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What Role Can Community Health Workers Play in Connecting Rural Women with Depression to the “De Facto” Mental Health Care System?

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Abstract

The prevalence of depression among rural women is nearly twice the national average, yet limited mental health services and extensive social barriers restrict access to needed treatment. We conducted key informant interviews with community health workers (CHWs) and diverse health care professionals who provide care to Appalachian women with depression to better understand the potential roles that CHWs may play to improve women’s treatment engagement. In the gap created by service disparities and social barriers, CHWs can offer a substantial contribution through improving recognition of depression; deepening rural women’s engagement within existing services; and offering sustained, culturally appropriate support.

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Notes

  1. Prevalence estimates vary because of the challenges of accessing rural women who are remote and may have diverse cultural interpretations of screening questions.

  2. Most CHWs are women, but some—like this participant—are men and can also be perceived as assets.

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Acknowledgements

The funding was supported by National Institutes of Health (Grant No. CTSA UL1TR000117), Office of Research on Women's Health (Grant No. K12 DA035150) and University of Kentucky Department of Behavioral Science. This research would not have been possible without the valuable perspectives of all of the participants who made time to share their expertise with us. Wayne Noble′s talents were critical for coordinating the study and other colleagues at the Center of Excellence in Rural Health offered vital feedback on interpreting the findings. We appreciate the insights of the editor and anonymous reviewers to strengthen the manuscript.

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Authors and Affiliations

  1. Division of Community Health Sciences, School of Public Health, University of California, Berkeley, 207H University Hall #7360, Berkeley, CA, 94720, USA

    Claire Snell-Rood

  2. Center of Excellence in Rural Health, Hazard, KY, USA

    Frances Feltner

  3. Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA

    Nancy Schoenberg

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  1. Claire Snell-Rood
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  2. Frances Feltner
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  3. Nancy Schoenberg
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Correspondence to Claire Snell-Rood.

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Snell-Rood, C., Feltner, F. & Schoenberg, N. What Role Can Community Health Workers Play in Connecting Rural Women with Depression to the “De Facto” Mental Health Care System?. Community Ment Health J 55, 63–73 (2019). https://doi.org/10.1007/s10597-017-0221-9

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