Community Health Workers: Bridge to Pediatric Mental Health Equity

Abstract

We currently face a national crisis in youth mental health and well-being and significant child behavioral health inequities. Addressing social determinants is a primary approach to achieving health equity. Social determinants of mental health (SDoMH) impact every child across the mental health services continuum, with inequities driven by discrimination across social class, race, gender, sexual orientation, physical ability, national origin, intellectual or mental abilities, and other group categories and combinations of group categories. While clinician passion, ingenuity, and support for advancing SDoMH resources and social justice are crucial, navigating rapidly changing community resources and tailoring the strategies for individual patients can be daunting for clinical personnel who are already overwhelmed with clinical loads. We build upon Cotton and Shim's (2022) call to action for clinicians to meet SDoMH needs across the public health framework/pyramid. A complementary approach builds upon this traditional clinician-driven model to a community team model. It adds a new team member, the community health worker (CHW). CHWs bring deep community ties, community relationships, and trust to support family-driven priorities around unmet SDoMH needs. They help families navigate the evolving local resources, contacts, and processes to meet SDoMH needs as well as social change. We share community team examples across geographies (urban and rural), settings (clinics, schools, churches), and clinical service delivery (traditional in-person and telehealth) aimed at improving child biopsychosocial outcomes.