Non-Clinical Mental Health Workers Model

Peer support workers are individuals who have experienced a mental health or substance use condition and have been successful in treatment. Peer support specialists can be trusted members of the community and may have similar, shared experiences to the individual seeking care. By connecting community members with an individual who has lived experience with a mental health condition, individuals may be more willing to engage in treatment services. Family peer advocates and youth peer leaders are additional examples of peer support models. For more information on peer support programs for individuals with a substance use disorder, see our Rural Prevention and Treatment of Substance Use Disorders Toolkit.

Other non-clinical professionals who can help connect community members to mental health services include:

• Behavioral health aides
• Community health workers
• Patient navigators

Non-clinical health worker positions are especially important to fill in rural areas because the traditional mental health workforce is smaller than in urban areas. Care from a non-traditional mental health provider may be accessible immediately through a drop-in service, unlike other clinical services. In addition, there may be less discomfort associated with receiving help from an individual who may not formally be considered a healthcare professional.

Mental health trainings for community members that can be adapted for rural audiences include:

• COMET (Changing Our Mental and Emotional Trajectory) teaches community members how to support a friend or neighbor who may be struggling with their mental health while emphasizing rural cultural values.
• QPR for Farmers and Farm Families teaches laypeople and professionals to recognize and respond to mental health crises, particularly in the agricultural community.

Examples of Rural Programs Using Non-Clinical Mental Health Workers

• Libraries for Health, launched by Via Hope and the St. David's Foundation, is a mental health program that collaborates with libraries in rural Texas to enhance access to mental health services and address the mental health needs of residents. Libraries for Health also includes a peer specialist training program. Built on a task shifting model, this program aims to equip individuals with lived experience in mental health, substance use, incarceration, and homelessness with the skills to identify the mental health concerns of library patrons and provide support.

Implementation Considerations

As peer support specialists emerge as leaders in the mental health workforce, it becomes imperative for rural programs to set clear standards in each area of work. The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies core competencies for peer workers in behavioral health services. The core competencies outline the knowledge, skills, and attitudes of a successful peer support worker. They address provision of support that is personalized and supports recovery; sharing of lived experiences; connection to resources, services, supports, and information; communication; collaboration with and support of peers; and promotion of leadership, advocacy, growth, and development. Rural programs can use the core competencies as a guide for best practices and qualifications for peer support.

Rural programs looking to address mental health workforce shortages should also consider task shifting. Task shifting, or task sharing, is the process of sharing tasks between highly trained, clinical healthcare providers and other professionals, such as peer support specialists, allied healthcare professionals, or non-traditional healthcare providers. Rural programs can implement task shifting interventions by leveraging support from community health workers. Our Community Health Workers Toolkit provides information on implementing community health worker programs in rural settings.

Program Clearinghouse Examples

• Arkansas Rural Health Partnership
• Families Plus
• Health Care Partners Foundation
• Sinnissippi Centers, Inc.

Resources to Learn More

Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview
Document
Discusses procedures for addressing mental health workforce challenges by using nontraditional professionals such as peer support workers and trained community members to assist in the provision of mental health services.
Author(s): Grant, K. L., Simmons, M. B., & Davey, C. G.
Citation: Psychiatric services, 69(5), 508–516
Date: 1/2018