From Clinics to Communities: Community Health Workers’ Perspectives on Taking on the Behavioral Health Care Manager Role for Community-based Geriatric Depression Treatment

Abstract

Collaborative care models (CoCM) improve late-life depression outcomes and access, but face implementation barriers into healthcare systems. Task-shifting the behavioral health care manager role (BHCM) of CoCM to community health workers (CHWs) in community-based settings may help expand quality depression care. We conducted a qualitative phenomenological study using semi-structured interviews with 15 certified CHWs from clinical and community-based organizations. Guided by the Theoretical Framework of Acceptability, we explored CHWs’ perspectives on strengths, attitudes, perceived self-efficacy, concerns and recommendations for taking on the BHCM role. CHWs reported that their rapport with the community, resource networks, and cultural alignment are strengths. They supported taking on this role to increase mental health access and expressed their prior health promotion and public health background aligns with the BHCM role, though additional training and supervision are needed to deliver psychosocial interventions, monitor symptoms, and infrastructure and role facilitation are needed to build capacity within community organization.