Harlem Strong Mental Health Coalition: A Multi-sector Community-Engaged Collaborative for System Transformation

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Abstract Addressing health disparities, especially in the face of COVID-19, requires an integrated multisector equity-focused, community-based approach. First, community-partnered networks to engage communities, strengthen community-based safety net systems, increase linkages to a wide variety of services, and promote community-wide MH awareness are needed.13 Second, task-shifting MH support skills to non-MH providers in gateway settings has been found to effectively address MH shortages worldwide, but has not been well studied in the U.S for low-income housing developments.14-18 Third, a syndemic approach can not only increase treatment engagement in health and mental health services, but also may offer greater effectiveness for ethnic minorities with multiple barriers to care.19 Guided by a CBPR process, our Harlem Strong Collaborative (CUNY Graduate School of Public Health, Harlem Health Initiative, Center for Innovation in Mental Health, and Harlem Congregation for Community Improvement) will be expanded to include Healthfirst (Managed Care Provider), and their network for primary care practices and Coordinated Behavioral Care (Behavioral Health Provider) to create a multisector coalition to work together to implement an expanded model of community collaborative care for evidence-based mental health to Harlem residents through two strategic gateways (low-income housing developments and primary care). We will also leverage other CUNY institutes, centers, and Firefly Innovations to support a hackathon focused on technological innovations to address barriers and needs identified by the Harlem Strong Coalition. Our proposal examines the impact of Harlem Strong Community Mental Health and Economic Empowerment Collaborative, a community-wide multisectoral coalition in which a health insurer works with community-based organizations and medical and behavioral health providers to (1) problem solve financing, access, and quality of care barriers, (2) support capacity building for mental health task-sharing for community health workers, (3) facilitate coordination and collaboration across mental health / behavioral health, primary care, and social services, and (4) identify a set of common metrics and strategies for continuous system quality improvement. The research study will evaluate the impact and cost-effectiveness using a hybrid Implementation-Effectiveness design to assess effects of the Harlem Strong Collaborative on system and consumer outcomes. We will also describe implementation outcomes and key informant interviews to explore impact of community engagement, organization variables, and provider factors on model impact. The long-term goal of our study is to develop a sustainable model for task-sharing mental health care that will be embedded in a coordinated comprehensive network of services.