Dr. Parnes and Colleagues Review 573 Articles on Strategies for Expanding the Child/family Mental Health Workforce for the CARE Codesign Team
Dr. McKenna Parnes
Dr. McKenna Parnes, a postdoctoral fellow with the UW Department of Psychiatry and Behavioral Sciences, is leading an effort with the CARE project to conduct a review of the research literature and present findings on “non-specialist” mental health service models for youth. Non-specialists are experts in community and personal experience supporting a child with a mental health need who are then supported to deliver aspects of formal mental health treatment.
Dr. Parnes’ literature review team reviewed 573 research studies and narrowed down the findings to identify the most common models of care seen in the literature.
Exploring the academic literature
The most rapid and transformative advances in expanding mental healthcare roles are occurring in low-and middle-income countries. Consequently, the team looked to the global health literature and the budding evidence-base in the U.S., to explore current models of therapeutic interventions being delivered to communities via non-specialist providers to support youth mental health.
Describing care models
The models of youth and family care presented in the academic literature can be distilled down into three categories: (1) parent peers; (2) community health workers; (3) youth peers.
Parent peers: A common model of care is one in which parents or caregivers who are also parenting a child with mental health needs (called peers) lead groups and individual sessions with other parents to provide emotional support, discuss specific parenting approaches, encourage self-care, and connect families to community resources.
Community Health Workers: Another common model involves community health workers, who are trusted members of the local community but who may not have specific experiences with mental health care. In these models, community health care workers are trained and supervised as they facilitate therapeutic groups with parents and youth, and may meet with families in individual sessions.
Youth Peers: Similarly, to parent peer models, the team also identified models of care in which youth aged 18-25 with previous/current experiences of mental health care were trained and supervised as they facilitated therapeutic groups and individual sessions with adolescents.
Presenting findings to the community
The CARE project is grounded in co-creation with the community, centering the experiences of community partners around Washington state with lived experience and expertise. Thus, Dr. Parnes’ team wanted to present the literature in such a way that the CARE teams (codesign, advisory and community sounding board) could absorb and critique these three models for their cultural responsivity and fit for Washington State families.
They decided to use storyboards, a visual design tool, to walk community partners through these various models of care. The storyboards are presented as comic panels and show either a caregiver or adolescent seeking mental health care. There are panels throughout the storyboards that offer an opportunity for interaction, allowing community members to describe what they believe a client might think or feel if they were in these situations.
We have been refining these storyboards with members of the CARE project co-design team to make sure the messages being conveyed align with community priorities. The final product will be shared with the broader community sounding board to invite input on what a client might say or do when seeking care, and to understand what kind of care model they would like to see for families in Washington state.
While the academic literature providers a jumping off point for generating ideas around potential models of care, the CARE project centers and prioritizes community voices to guide decision making around what a model of care should look like for Washington state families. We, on the CARE team, are so grateful to have community partners to learn from and who are willing to work with us to design a better model of youth mental health care, and we are excited to see how these efforts will lead to positive and lasting change.
To learn more about CARE for Kids & Families, visit uwcolab.org/CARE.