Community Health Workers in Perinatal Mental Health: Feasibility and Challenges of Implementing a Task-Sharing Model

Area of Science:

• Public Health
• Mental Health Services Research
• Community Health

Background:

• Community health workers (CHWs) possess potential for addressing maternal mental health needs.
• Perinatal mood and anxiety disorders (PMADs) represent a significant public health concern.
• Existing task-sharing models require adaptation for effective community-based implementation.

Purpose of the Study:

• To assess the feasibility and acceptability of implementing the Thinking Healthy Program (THP) via CHWs in community-based organizations (CBOs).
• To explore stakeholder perspectives on CHW roles and challenges in managing PMADs.
• To evaluate changes in CHW knowledge, comfort, and confidence in addressing maternal mental health.

Main Methods:

• Adaptation of the World Health Organization-endorsed Thinking Healthy Program (THP).
• Implementation across six community-based organizations (CBOs) in central and western New York.
• Qualitative interviews with CHWs, supervisors, and executives; pre- and post-implementation surveys with CHWs and supervisors.

Main Results:

• Qualitative data revealed community need, current CHW roles, and resource gaps for task-sharing.
• Post-implementation surveys showed a decline in CHW self-reported knowledge, comfort, and confidence.
• Supervisors observed improvements in CHW skills, indicating mixed outcomes.

Conclusions:

• Implementing task-sharing for PMADs with CHWs faces critical challenges.
• Sustained supervision, attention to organizational context, and strategies for workforce stability are essential.
• Further research is needed to optimize CHW engagement in maternal mental healthcare.