Restoring mental health through community-based psychological services in New York City (RECOUP-NY)

In the U.S., training staff at community- based organizations (CBOs) to deliver psychological support has been highlighted as a way to increase availability of mental health services and increase access to mental health care. We propose to employ a mental health task-sharing model by partnering with CBOs in NYC to train CBO staff without professional mental health training to deliver mental health services. We will examine the impact of CBO staff delivering mental health services to improve mental health outcomes including reduced general psychological distress, depression, and anxiety, as well as improve economic outcomes including saving on healthcare expenditures. We propose a cluster randomized control trial (cRCT) in NYC comparing Services as Usual (SAU arm) and delivery of mental health services with Problem Management Plus (PM+) (Intervention arm) among CBOs offering services for housing, job training, financial literacy, and other social services promoting independent productive livelihoods. The target conditions will be psychological distress, depression and anxiety. We will evaluate mental health outcomes of populations served by CBOs integrating PM+ into their other activities compared to CBOs delivering SAU. We will evaluate implementation processes to inform policy recommendations for community-based delivery of psychological interventions and inclusion of mental health to improve outcomes of other social services (e.g., integration of PM+ to improve financial, employment, and other independent productive livelihood skills). Successful completion of these aims will contribute to the NIMH Strategic Plan. Specifically, a) employing implementation science to maximize the impact of research for improving effectiveness and reach of mental health services b) strengthening research-practice partnerships to expedite adoption, sustained implementation, and continuous improvement of evidence-based mental health services; and c) developing innovative service delivery models to dramatically improve outcomes of mental health services for the goals of promoting employment, housing stability, and promoting savings on healthcare costs.