CRISOL Mente: A Multilevel Community Intervention to Reduce Mental Health Disparities Among Latinos - Latinos in the U.S. experience significant barriers to access mental health services due to lack of health insurance, cost of services, limited knowledge of mental health resources and negative attitudes towards individuals experiencing mental health problems. Limited English proficiency coupled with an acute lack of bilingual providers further impede Latinos’ adequate access to quality mental health services. The COVID-19 pandemic has only amplified the need for mental health care and exacerbated mental health conditions for Latino communities, making it urgent to identify low-cost, effective strategies to reduce these gaps. This 5-year project seeks to develop and test a multi-level, community intervention to improve mental health outcomes and promote access to appropriate mental health treatment for Latino communities in Philadelphia. CRISOL Mente will include components at various levels of the socio-ecological model: a clinicbased, stepped-care program relying on lay health workers (LHW) for the delivery of mental health services (Aim 1), outreach and education activities to promote mental-health treatment seeking in the community (Aim 2), and efforts to strengthen service providers’ capacity to address mental health and other syndemic conditions contributing to untreated mental health among Latinos (Aim 3). To improve mental health symptoms and engagement in care, we will recruit, train and supervise a cohort of LHW who will be embedded into two community-based clinics, extending the reach and effectiveness of the clinics’ mental health services. We will compare the impact of three different levels of LHW involvement: a) community outreach/navigation (i.e. screening and referral of community members); b) auxiliary care (i.e. screening, referral, and help overcoming barriers to better mental health); and c) task shifting (i.e. screening, referral, assistance, and supervised delivery of basic mental health treatment). The LHWs will also conduct outreach/education activities in the community (e.g. radio talks, info sessions, tables in community venues) to promote utilization of mental health services among individuals with mental health needs. Our experienced community-academic research team will also engage in capacity building activities (i.e. monthly town halls, annual retreats, weekly newsletters, provision of trainings and technical support) with the Latino Health Collective, a coalition of communitybased organizations (CBOs). Using mixed-methods and the RE-AIM framework, CRISOL Mente’s impact will be evaluated with clinical data, baseline and 6-month patient survey data (N=200 from each level of LHW involvement), and qualitative interviews with community members (N=30) referred to mental health services by the LHW (Aim 1); pre/post utilization of mental health services comparing data from two respondent driven sampling (RDS) surveys of Latinos (N=400 each) conducted in 2022 (preliminary study) and in 2027 (Aim 2); community capacity indicators from three surveys of CBOs conducted in 2019, 2021 (preliminary studies) and 2027, and key informant interviews (KII) with service providers (N=30) in 2019 (preliminary study) and 2027 (Aim 3).
