Panel Discussion 17 - Community-engaged Efforts to Support Paraprofessional-delivered Mental Health Services: Navigating Organizational and Systemic Implementation Determinants in Diverse Settings and Interventions

Growing evidence demonstrates the effectiveness of paraprofessional delivered, evidence-based practices supporting mental health. Task-shifting models that incorporate paraprofessionals (PPs, also referred to as lay/community health workers, promotores, peer support specialists) are increasingly leveraged to address persistent mental health disparities for marginalized populations given PPs’ unique strengths in facilitating community engagement as members of the community served. However, to fulfill their potential for reducing mental health inequities, these models will need to be scaled and integrated into service systems (i.e., healthcare systems, community organizations) while retaining ecological specificity. This panel will describe the range of roles PPs can have in mental health models from prevention to intervention across a range of settings, explain the evidence from systematic reviews establishing their effectiveness, and discuss the supports needed for sustainable implementation of these models. Using an implementation science lens, we will focus our discussion on two implementation determinant domains identified as consistent barriers to implementation: organizational and systemic (i.e., healthcare system, policy). Within the organizational domain, we will discuss the infrastructure organizations must provide to support PP services, including training, supervision, support, and integration of these services into a broader spectrum of care. Within the systemic domain, we will discuss policy, reimbursement mechanisms, and the labor landscape for PPs. Panelists have rich and diverse experiences researching and working alongside PPs delivering a range of mental health services, including community health workers embedded in healthcare, behavioral health settings, and community-based organizations, youth mentors and afterschool program staff working in community-based organizations, and PP family liaisons working in schools. Leveraging this expertise, panelists will address implementation considerations, challenges, and practice recommendations relevant to organizational and systemic determinants for PP models, and highlight the role of community partnerships and engagement in this work.