PROJECT SUMMARY This application is in response to the NIH Common Fund Transformative Research to Address Health Disparities and Advance Health Equity at Minority Serving Institutions (RFA-RM-22-001). The objective of this project is to implement a scalable task-sharing model aimed at building capacity and supporting a racially diverse workforce of non-specialist providers to deliver brief interventions for the indicated prevention and early intervention for depression and anxiety, combined with new content tailored to the local context in low resource, racial and ethnically diverse settings with emphasis on assessing and addressing the social determinants of mental health in these communities, ultimately contributing to the reduction of disparities in their communities. We will do so by recruiting from the undergraduate student population at a Minority Serving Institution in Texas, one of the most under-resourced states for mental health care and deploying an innovative suite of digital solutions to train, supervise and support these providers to deliver evidence based, brief, quality assured psychosocial interventions. The intervention, designed through a systematic process of co-production with students, and collaboration with community specialists, will aim to achieve trans-diagnostic intervention for common mental health problems such as depression and anxiety. The long-term goal of the project is the creation of resources, opportunities, structure, and scaffolding that will establish a robust community mental health care system, through deployment of providers, trained and certified as Community Health Workers (CHWs) for scaling up and building capacity for delivery of interventions to shift mental health care away from specialty care toward high-frequency, low-cost interventions in the communities where the providers live. Increasing the number of providers who reflect the demographics of the community they are serving is key to addressing gaps in care as well as addressing social determinants of mental health and disparities in access to care among minority groups.5 We propose to leverage EMPOWER, a platform developed by Patel and Naslund4 at Harvard Medical School with support from the National Institute of Mental Health (U19MH113211), to train non-specialist undergraduate social work students, facilitate peer supervision for support and quality assurance, and provide consultation and real time support to certified CHWs in the community. The EMPOWER curriculum consists of evidence-based psychosocial interventions covering foundational counseling skills and behavioral activation and will be augmented with training content focused on recognizing and addressing the social determinants of disparities in mental health. Central to our implementation plan and sustainability strategy is to leverage the infrastructure of the Lone Star Depression Challenge, a statewide effort in partnership with the EMPOWER program which will engage, train, and deploy CHWs to health systems to reduce barriers for all Texans with depression, detect their needs earlier, and care for them more effectively, while also prioritizing and engaging people of color, individuals with disabilities, and those living in poverty.

PROJECT NARRATIVE The proposed study will transform mental health care by addressing both supply and demand side barriers through provision of accessible and evidence-based care delivered by racially and culturally congruent providers; enabling care to be delivered regardless of a formal diagnosis; and empowering majority-minority, mostly first- generation college-attending students to acquire the skills to respond and become change agents for their communities in Texas, a region with some of the greatest unmet behavioral health needs in the country. Importantly, through specialized training, tangible Community Health Worker certification, and focused mentorship with a team of faculty from historically underrepresented race/ethnic groups, the academic and career trajectory of students at risk for prolonged undergraduate enrollment or, worse, dropout may be altered. This transformative project has important implications for further dissemination and widespread understanding of the organizational and contextual factors which act as barriers to implementation of evidence-based interventions and can serve as a blueprint for guiding Minority Serving Institutions across the country to address the mental health needs of racial and ethnic minority groups in low resourced communities who have experience disparities in access and outcomes.