One in five adults experience mental illness in a given year, and mental health conditions are exacerbated among minority groups. For example, the rate of depression among black youth is 30% higher than the average for their age group. Multiracial US adults are more likely to experience mental illness than adults who identify as any single race. Lesbian, gay and bisexual adults are twice as likely as heterosexual adults to experience a mental illness, according to the National Alliance on Mental Illness. These groups also may face structural, financial, and cultural barriers to getting care.
Below are three health care workforce trends that may increase access to care for these populations.
Community Health Workers/Promotores
The American Public Health Association defines community health workers and promotores(CHW/Ps) as “frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served.” Integrating CHWs and promotores into more traditional clinical care models is proving to have direct impact on addressing social determinants of health, enhancing patient care, and improving access to health care and social services. Creating a sustainable community health workforce will require institutional and cultural change in health care systems.
Peer providers are individuals who provide services in behavioral health settings, both for mental health and substance use disorders (SUDs) treatment; they use their own experience of recovery from mental illness or addiction and skills obtained from formal peer provider training to serve their patients. Like CHWs, they are often part of underrepresented groups and connect with clients because of their lived experiences and similar backgrounds. Their inclusion in care models marks the transformation from behavioral health care to a “recovery-oriented” model of care. Healthforce research indicates that peer providers are uniquely positioned to support the long-term recovery of people with mental health and substance use disorders. The US Department of Veterans Affairs hires peer specialists to help patients identify and achieve specific life and recovery goals, and a number of organizations in California use peers in transitional settings to serve as navigators and mentors for the formerly incarcerated and those recently discharged from a psychiatric hospitalization.
Psychiatric Mental Health Nurse Practitioners
Psychiatric mental health nurse practitioners care for patients with mental health and behavioral health needs. Healthforce research indicates that restrictive scope of practice laws for these professionals adds costs and diminishes accessibility. Full nurse practitioner practice authority allows for more efficient utilization of PMHNPs and may increase access to services.
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