The Power of Trust: How Community-BasedWorkers Can Close the Mental Health Access Gap

A growing number of adults and children have mental health conditions, but more than half of adults and an alarming 60% of youth go untreated. At one end of the problem is a persistent nationwide shortage of trained mental health professionals. On the other is the reluctance of patients — especially patients from historically marginalized communities — to seek help at all.

In a new study published in the Community Mental Health Journal, we highlight the crucial role of frontline caregivers, often referred to as “Behavioral Health Support Specialists.” This group includes Community Health Workers in mental health, Peer Support Specialists, Lay Counselors, and Patient Navigators, similar to those used in cancer care. These professionals play a vital role in addressing both aspects of the issue.

These workers provide a system-wide solution to the current workforce shortages. First, Community Health Workers help trained medical professionals to focus on those with the greatest needs through task-shifting. They help triage incoming cases. They attend to patients’ non-medical psycho-social-behavioral needs. They coordinate care across the fragmented systems that serve those with mental health conditions. And they manage recovery monitoring, a crucial component of care that includes follow-up calls and local outreach visits that overextended doctors and nurses often cannot attend to.

Second, like patient navigators, promotores de salud, and other informal care facilitators, Community Mental Health Workers come from the communities they serve. They look like their prospective patients, frequent familiar places of worship and schools, and often share a common culture and background. Many — known as “Peer Support Specialists” — have lived experience facing the same life conditions and challenges as their clients. These unteachable qualities increase patients’ connections to care by lowering real and perceived barriers. These workers, just by being themselves, can transform medical settings into more welcoming places and guide with empathy — reaching even the most reluctant patients.

Their work with patients is documented extensively in our study — and astonishingly impactful. A 2023 study, for example, found that nurse-led federally qualified health clinics that integrated specially trained traditional community health workers into their care saw “an increase in depression screening and follow-up from 15.7% to 91.2%.” Meaningful findings like these abound in academic literature for each type of worker—and the study brings the evidence together into one narrative.  Read about the impact of these workers here.