Implementing Mental Health Task Sharing in Community-Based Services to Engage Older Chinese Immigrants in the U.S. in...

Older Chinese immigrant adults in the United States, the fastest-growing population among older immigrants, have low service utilization rates despite a high prevalence of mental health disorders. Mental health task-sharing, the delegation of low-intensity mental health tasks to non-licensed providers in community-based settings, has been implemented to improve access, yet research on engaging older Chinese immigrants remains limited, particularly in immigrant-serving community-based organizations. This study aimed to identify barriers and facilitators to engage older Chinese immigrants in the implementation of mental health task-sharing in community-based social services. Semi-structured interviews were conducted in 2023 with 30 frontline providers and administrators from 17 community-based organizations, including older adult centers, social adult day care, and Naturally Occurring Retirement Communities in New York City. Two coders coded transcripts independently and conducted thematic analysis using ATLAS.ti 24, guided by the Consolidated Framework for Implementation Research (CFIR). Results suggest barriers to engagement included community-level stigma and cultural beliefs, with older Chinese immigrant adults fearing negative social consequences within close-tie communities. Facilitators included building rapport, rephrasing mental health terminology, connecting mental health and physical health, and offering payment assistance. Addressing stigma and cultural beliefs was crucial for engagement in task-sharing implementation. Older Chinese immigrants can be effectively engaged by using culturally informed strategies to facilitate mental health task-sharing implementation.