Implementing community health worker-delivered behavioral health models: A primer for healthcare organizations

Mounting evidence demonstrates the effectiveness of community health worker (CHW) delivered behavioral health (BH) interventions, identifying them as a promising strategy to address the growing unmet BH needs in the United States. However, sustainable CHW BH models require not only a CHW workforce trained in the delivery of BH interventions, but also organizational and systems infrastructure to support ongoing implementation.

This Commentary describes lessons learned from Sinai Urban Health Institute, a community-engaged research center based in a safety net healthcare system, that since 2000, has developed, implemented, and evaluated CHW models, including CHW BH services.

Using an implementation science lens, we apply lessons learned to delineate challenges and recommendations for implementing CHW BH models, focusing on addressing implementation determinants at the organizational and health system levels, as these domains were identified in a systematic review as particularly prevalent and challenging determinants to address. Integrating CHW BH services into health systems will require investments in supervisors for CHW BH models, material resources, team building with partnering clinics, relationship building with community partners, and policy advocacy.