Harvard Catalyst Profiles

The United States is facing a mental health crisis and an increase in the mental health treatment gap, exacerbated by the COVID-19 pandemic. Low- and middle-income countries (LMICs) have historically grappled with even greater mental health challenges. Therefore, LMICs have thought creatively about decreasing the mental health treatment gap and the settings in which to deliver evidence-based and equitable mental health care. One of the most notable interventions is the inclusion of community health workers (CHWs) in the mental healthcare system. To that end, there is much to learn in the US from LMIC in a mutual capacity-building way. The scholarly project would focus on the status quo of CHWs globally and in the US specifically and analyze if and how CHWs should be utilized in the US to decrease the mental health treatment gap. A potential framework for the scholarly project could be: 1.) What is the gap (motivation of why we need to expand the US mental health workforce to non-specialists such as CHWs, discuss the idea of task-shifting) 2.) Global definition of CHWs and their different scopes, both in terms of general health and in terms of mental health 3.) What is the evidence of CHWs in the mental health systems/in delivering mental health care across different populations/mental health conditions, etc. 4.) Discuss the potential scope of practice of CHWs in the mental health care system in the US (can discuss expected outcomes, licensing/patient safety/liability issues, and training needs) 5.) How to fund CHWs: a) how are CHWs currently funded in LMICs, b) how are CHWs currently funded in the US (discuss experiences from different states), c) additional ideas of how CHWs could be funded 6.) How do we learn from LMIC in the US (discuss the idea of mutual capacity building) The student would be responsible for a thorough literature/document review.

Kenya is one of the few African countries that have a mental health policy and action plan. Kenya has 47 counties. Healthcare in Kenya is decentralized, i.e, the national governments passes legislation and the county governments implement the legislation. To cater to county-specific circumstances, counties need to adjust the national mental health policy and action plan at the county level. Kisumu County, one of the 47 counties, recently passed the county-specific Kisumu County Mental Health Action Plan 2024-2029. However, Kisumu County is diverse, and the seven sub-counties differ significantly in terms of prevalent mental health conditions, service user demographics, and available treatment resources. The Kisumu County Government needs to analyze how the current county-wide mental health action plan can be adjusted to the sub-county level to access quality mental health care and reduce the mental health treatment gap. The students will do desk research, a literature review, ecosystem mapping, and a landscape analysis.