Table 1.

Community input into development of community health worker training program

Themes	Quotations
What are the needs of New Orleans residents?
Multiple problems	“Most people before the storm could handle their issues, but afterwards, it was difficult to deal with because all the problems were adding up.”
Difficulty of housing	“It's always housing issues.”
Vulnerable populations and mental health issues	“There are a lot of scary things being noticed in the community in terms of children without parents in homes by themselves, people not able to find jobs and not having any hope for dealing with rebuilding issues, elderly folks living alone on dark streets with no relatives checking on them, children in desperate need of mental health interventions.”
Suicidal clients	“Just talking to them straight out. Are you having thoughts of killing yourself? They want someone to listen to them, and are relieved that I brought it out.”
	“I met a woman in the doctor's office who wanted to die.”
Fit with agency scope	“They say ‘I need this fixed’ rather than accepting assistance.”
	“75% of clients are hard to get a follow-through because what you are offering is not direct enough.”
Continuing stressors	“We are back from (evacuation due to hurricane) Gustav and seeing people in the community centers and counseling offices whose needs have only increased.”
How is mental health outreach currently conducted?
Lack of mental health outreach programs	“There is nothing out there in the community that addresses the needs of mental health outreach workers.”
Knowledge of local needs	“History of serving low-income and/or African-American populations of post-disaster Greater New Orleans area.”
Engage in client's story	“I want to hear your story, tell me what you're experiencing.”
Support without enabling	“There is a thin line between empowering and enabling.”
Faith-based support	“I had to go to the Bible.” “I pray with them.”
Build trust	“We deal with building the trust of community folks to work with them.”
Flexible style	“Let people know that we are here for them and won't abandon them.”
	“Need to be flexible in terms of meeting people on their own terms.”
What do CHWs and community-based organizations need to address stress and depression in New Orleans?
Resources/staff	“Get so many (clients) that you become overwhelmed.”
	“Clients are responding, but would respond better if we weren't standing on someone's porch going door to door.”
	“A place we can refer our clients—that's our big need as case management.”
Funds for medication	“One of the major problems we have is funds for medication.”
Self-care/personal treatment	“You need to treat yourself as a patient.”
	“Discussion of having recently trained counselor run support group for outreach workers for mutual benefit.”
Integrate into existing programs	“Work with other programs—nutrition for high school students, encourage exercise and healthy habits.”
Agency capacity and accountability	“The vast majority of those agencies are not doing what they say they are doing; lack of direction; no enforcement mechanisms.”