Psychiatric Research and Clinical Practice · Published 2025-05-02 · DOI 10.1176/appi.prcp.20250027
Objective In 2022, half a million residents of New York City reported being unable to access mental health services. One solution to combat this service gap is community‐initiated care (CIC), in which staff, who are not mental health specialists, at community‐based organizations (CBOs) identify clients experiencing distress and then deliver a brief psychological intervention. CIC is intended to reduce barriers to accessing care, lessen costs, and prevent stigma. In this protocol, we describe a trial designed to evaluate implementation of CIC in New York City using a psychological intervention that has been successful globally for rapid deployment by people who are not licensed mental health clinicians. Methods This protocol describes a cluster randomized controlled trial that will compare CBOs where non‐clinical staff are trained to deliver the World Health Organization's Problem Management Plus (PM+) intervention versus CBOs providing care as usual. Forty‐two CBO sites, the unit of clustering, will be randomized 1:1 to either condition. Approximately 1000 CBO clients (26–28 per site) will be recruited. Approximately 45 CBO staff (2–3 per site) in the intervention arm will be trained to deliver PM+. The primary outcome is distress at 20 weeks post‐baseline, assessed with a personalized measure of psychological distress (the Psychological Outcome Profiles Questionnaire). Cost‐effectiveness will be evaluated. Ethical approval: August 3, 2022. Conclusions The study described in this protocol will yield evidence on effectiveness of CIC delivered by non‐clinical staff. Findings will help policymakers determine how to invest in and support non‐clinicians in the United States and globally.
Abstract from DOAJ. Public domain (CC0 1.0).
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