What did CHWs think of the training and materials?
|
|
Informative |
“Training was well done, well put together, very informative and educational for those who wouldn't have as much knowledge on a particular subject.” |
|
“The role-playing on how to deal with difficult clients was very interesting.” |
What components are CHWs using?
|
|
PHQ-2 and PHQ-9: Strategies for use of screening and referral resources |
“Several of our workers have used the PHQ-2.” |
“Paraphrasing (screening items), so we could understand each other.” |
|
“I suggest they go to a clinic because I don't want them to say I said they have ‘such and such.’ When they come back I ask about the visit and then ask the questions and present the options.” |
Confidentiality tools |
“Confidentiality materials were helpful, especially HIPAA laws” |
Behavioral activation |
“Elderly man who develops a plan to get off bus one block early to return to exercise, feels better; then gets off 2 blocks early and runs into a friend.” |
How can CHW training and support materials be improved?
|
|
Case registry |
“The form is too long, break it down. Some questions need to be eliminated.” |
Cultural competence |
“Spanish version or simplified version for folks with low education.” |
|
“Would like a more community-oriented approach and language.” |
More role playing |
“People need more practice and a practice session is very helpful.” |
More relationship building |
“Needs to be a greater effort to get them all to talk. Have everybody exchange phone numbers and have some conversations.” |
Therapy for CHWs |
“Having recently trained counselor run support group for outreach workers.” |
Integrate with counseling skills |
“You created an artificial distinction between counseling and outreach piece, that didn't work (for our needs in mental health agency).” |
What are the challenges associated with implementing the CHW role?
|
|
Community infrastructure |
“Reluctance to call police because of the way they handle it sometimes.” |
|
“Limited hospital services.” |
|
“Long wait for buses.” |
Client resistance and denial |
“We get the ‘I'm not crazy.’” |
|
“Denial issues.” |
|
“People don't want to go to care.” |
|
“When we try to get people to accept some responsibility, people get upset with us and report us to the front office.” |
Hard-to-reach clients and clients with complex issues |
“‘Catch me if you can’ clients.” |
|
“When I called her the following week, have not been able to get through.” |
|
“Try to reach family to follow-up with elderly.” |
|
“Clients dealing with multiple issues—health is last.” |
|
“Problems on top of problems.” |
Job conditions |
“Work force too small, pay too little.” |
|
“Management is not on the same page.” |
Agency relationships and provider collaboration |
“Don't have the interrelationships within and between agencies.” |
|
“Still trying to collaborate (to find a) place we can refer our clients.” |
|
“Outreach workers could work more closely with providers, churches.” |
What is the early impact?
|
|
Hope |
“It gives us all hope...It's good that you started that process.” |
Networking |
“The most important thing is that we stay in touch to make sure we are working on the same basis so we can all help each other.” |
|
“We increased ease of getting help for clients, working with other agencies.” |
|
“Do a resource network of mental health and rehabilitation providers. That would be a great service you could do.” |
Certification |
“Our agency pre-Katrina, failed Joint Commission because we did not do this. They will look to see if you have things like this in your program.” |
Improved quality and funding |
“Helps set our own standards, better opportunity to shine, clarify ourselves, and get more money.” |
Perception of providers |
“First time realized these providers want to do well.” |