Exploring patient perspectives on a new task-shared behavioral health role in Washington State

Mental health provider shortages lead to substantial treatment gaps for mental health services worldwide, including throughout the United States. Task-sharing, in which providers with no or limited prior training in mental health care are trained to deliver psychological interventions, is a leading strategy to increase capacity, yet it has been under-utilized in the US to date. Recent legislative changes are starting to enable opportunities for task-sharing mental healthcare in the US. A leading example is Washington State's introduction of the Behavioral Health Support Specialist (BHSS), a supervised bachelors-level mental health provider role. However, little is known about patient perspectives on task-sharing mental health care within US settings. Our study engaged potential future patients at two integrated care clinics (n = 40) using mixed methods data collection (semi-structured individual interviews and brief structured surveys adapted from the acceptability and appropriateness sub-scales of the Mental Health Implementation Science Tools) to explore potential patient perspectives on the perceived acceptability and appropriateness of these reforms in the US. We identified three main qualitative themes: (1) Overall, potential patients reported that they perceived task-shared mental health care to be acceptable; (2) Potential patients reported familiarity with task-sharing from other clinical and community settings; and (3) Potential patients shared hesitations and questions that are important for implementers and educators to address. Quantitatively, most participants reported moderate to strong support for receiving care from a task-shared mental health provider. Given that legislative reform expanding care delivery via these roles is already well underway, our findings can help support successful implementation of a bachelor's level mental health provider role. Though the scope of this bachelor's level role is currently limited to Washington, other states are exploring introducing similar roles to their mental health workforce, so these findings may be applicable nationwide.