Expanding the Non-Clinical Mental Health Workforce: Protocol for a Randomized Controlled Trial of a Psychological Intervention Delivered by Community-Based Organizations in New York City (RECOUP-NY)

Brandon A. Kohrt, Department of Psychiatry and Behavioral Health Center for Global Mental Health Equity George Washington University Washington District of Columbia USA.
Manaswi Sangraula, Department of Psychiatry and Behavioral Health Center for Global Mental Health Equity George Washington University Washington District of Columbia USA.
Elizabeth L. Turner, Department of Biostatistics and Bioinformatics and Duke Global Health Institute Duke University Durham North Carolina USA.
Kendall Pfeffer, Department of Psychology The New School for Social Research New York New York USA.
Chynere Best, Department of Psychiatry and Behavioral Health Center for Global Mental Health Equity George Washington University Washington District of Columbia USA.
James Caracoglia, Department of Psychiatry and Behavioral Health Center for Global Mental Health Equity George Washington University Washington District of Columbia USA.
Alejandra Cid-Vega, Department of Psychology The New School for Social Research New York New York USA.
Wilfred Gwaikolo, Department of Psychiatry and Behavioral Health Center for Global Mental Health Equity George Washington University Washington District of Columbia USA.
Caroline McEneaney, Department of Psychology The New School for Social Research New York New York USA.
Alyssa Platt, Department of Biostatistics and Bioinformatics and Duke Global Health Institute Duke University Durham North Carolina USA.
Cheenar Shah, Department of Psychology The New School for Social Research New York New York USA.
Shifeng Sun, Department of Biostatistics and Bioinformatics and Duke Global Health Institute Duke University Durham North Carolina USA.
Janus Wong, Department of Psychology The New School for Social Research New York New York USA.
Kala Ganesh, NYC Mayor's Office of Community Mental Health New York New York USA.
Eliot Assoudeh, NYC Mayor's Office of Community Mental Health New York New York USA.
Eva Wong, NYC Mayor's Office of Community Mental Health New York New York USA.
Alastair van Heerden, WITS Health Consortium University of the Witwatersrand Johannesburg South Africa.
Adam D. Brown, Department of Psychology The New School for Social Research New York New York USA.

Document Type

Journal Article

Publication Date

1-1-2025

Journal

Psychiatric research and clinical practice

Volume

7

Issue

3

DOI

10.1176/appi.prcp.20250027

Abstract

OBJECTIVE: In 2022, half a million residents of New York City reported being unable to access mental health services. One solution to combat this service gap is community-initiated care (CIC), in which staff, who are not mental health specialists, at community-based organizations (CBOs) identify clients experiencing distress and then deliver a brief psychological intervention. CIC is intended to reduce barriers to accessing care, lessen costs, and prevent stigma. In this protocol, we describe a trial designed to evaluate implementation of CIC in New York City using a psychological intervention that has been successful globally for rapid deployment by people who are not licensed mental health clinicians. METHODS: This protocol describes a cluster randomized controlled trial that will compare CBOs where non-clinical staff are trained to deliver the World Health Organization's Problem Management Plus (PM+) intervention versus CBOs providing care as usual. Forty-two CBO sites, the unit of clustering, will be randomized 1:1 to either condition. Approximately 1000 CBO clients (26-28 per site) will be recruited. Approximately 45 CBO staff (2-3 per site) in the intervention arm will be trained to deliver PM+. The primary outcome is distress at 20 weeks post-baseline, assessed with a personalized measure of psychological distress (the Psychological Outcome Profiles Questionnaire). Cost-effectiveness will be evaluated. Ethical approval: August 3, 2022. CONCLUSIONS: The study described in this protocol will yield evidence on effectiveness of CIC delivered by non-clinical staff. Findings will help policymakers determine how to invest in and support non-clinicians in the United States and globally.

Department

Global Health

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