203720 Community health workers as an integral part of a collaborative care team to address depression and PTSD in post-disaster New Orleans

Monday, November 9, 2009: 1:10 PM

Diana Meyers, RN, BSN , Community Wellness Director, St. Anna's Episcopal Church, New Orleans, LA
Charles Allen, MPH , Tulane/Xavier Center Bioenvironmental Research, Tulane University, New Orleans, LA
Kenneth Wells, MD, MPH , Health Services Research Center, UCLA Semel Institute for Neuroscience & Human Behavior, UCLA, Los Angeles, CA
Steven Vannoy, PhD, MPH , Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Ashley B. Wennerstrom, MPH , School of Medicine, Tulane University, New Orleans, LA
Benjamin Springgate, MD, MPH , Tulane University School of Medicine and RAND Corporation, New Orleans, LA
Elizabeth O'Toole, MSPH , Health Services Research Center, UCLA Semel Institute for Neuroscience & Human Behavior, UCLA, Los Angeles, CA
Hurricane Katrina had a prolonged and marked mental health impact on the population of New Orleans and challenged the mental health care delivery infrastructure. Coupled with the stigma of depression, many people are suffering from depression and/or PTSD. While the need for information and resources to address mental health needs has been great, there are few community-based mental health outreach models in the literature.

The REACH NOLA community-academic partnership, dedicated to supporting health recovery in New Orleans, initiated the Mental Health Infrastructure and Training Project (MHIT) to address the lack of capacity and challenges in access to care for depression and post-traumatic stress disorder. Community agency leaders, academics, health-care organizations and grass-roots community members collaborated to develop a new mental health outreach model and training and supervision program, designed to be compatible with the collaborative care model of chronic disease management as applied to depression and post-traumatic stress disorder. The approach features community engagement, screenings, education, and referral, behavioral management skills, and suggested strategies to facilitate entry into and coordinate care, and to track client services and progress. We evaluated feasibility and described outreach worker responses through minutes, field notes, surveys, and semi-structured interviews collected during several rounds of training of outreach workers in New Orleans. Our experience and data suggest that such comprehensive mental health outreach programs are feasible and fill an important gap in community capacity for vulnerable populations following a major disaster, by reducing stigma, offering tangible social support, and facilitating entry into care.

Learning Objectives:
1. Describe the benefits of using CHWs to access mental health care 2. Identify CHW positions that could utilize this model 3. Describe two CHW roles in the collaborative care model for treating stress, depression and PTSD

Keywords: Community Outreach, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a key partner in the development of the Outreach Worker training program through REACH NOLA's Mental Health Infrastructure and Training Program and utilize the components of this training in our provision of medical and mental health outreach and care to underserved people in New Orleans. I have worked as the Manager of and Education Department at a local hospital and have presented at 2 organizational conferences as well as many smaller seminars.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.