From clinics to communities: community health workers’ perspectives on taking on the behavioral health care manager role for community-based geriatric depression treatment

OBJECTIVES: The Collaborative Care Model (CoCM) is an evidence-based model designed for primary care and has shown improved late-life depression outcomes. This study explored the perspectives of a non-specialist workforce, community health workers (CHWs), on adapting CoCM to community organizations by expanding CHW roles to include that of behavioral health care manager (BHCM). METHOD: Guided by the Theoretical Framework of Acceptability, we conducted semi-structured interviews with CHWs from community-based and clinical settings across five states.Participants discussed their attitudes, perceived self-efficacy, and recommendations regarding four BHCM tasks: administering behavioral health measures, using a patient registry, collaborating with mental health specialists and primary care providers, and delivering psychosocial interventions. Thematic analysis was used to analyze the data. RESULTS: CHWs expressed interest, support, and perceived self-efficiacy, with traiing and supervision, for the proposed role expansion, and cited alignment with their mission and community needs. Their strengths included community trust, linkage, and knowledge of resources as a workforce. Collaborating with mental health specialists was viewed as a model strength, but collaboration with primary care providers was a potential barrier. CONCLUSION: Findings support the acceptability of developing a BHCM workforce among CHWs, but understanding the perspectives of other stakeholders would be warranted for CHW role redesign.