Within mental health services, persons in recovery from their own experiences of mental health challenges (peers) are increasingly being trained to provide peer support. This study describes individual and organizational outcomes related to engaging peers in a multisite demonstration project in California that sought to integrate them as cocreators throughout planning and implementation of digital mental health interventions. We collected data from key informants across 11 sites. Quarterly online surveys invited key informants to report perceived outcomes of the peer component. Biannual interviews elicited details regarding survey-reported outcomes. Quantitative data provided indications of outcome prevalence and consistency, and quotes from the interviews illustrated the complex realities underlying survey responses. One hundred three quarterly surveys and 39 biannual interviews were completed between Summer 2020 and Fall 2022. Key informants reported diverse outcomes, including integration of peer input into local decision making, mental health benefits to peers and community members, reduced workplace mental health stigma, and new cross-site collaborations. Five sites reported outcomes with greater consistency compared to the other six sites. Reports of increased peer visibility in the workplace coincided with reports of reduced stigma and increased value of peer input by mental health professionals. This study offers encouragement for the potential positive impact of engaging peers as cocreators of mental health interventions. Data suggest integrating peers does not increase mental health stigma and may instead result in various positive outcomes. The degree to which these outcomes manifest in a specific setting, however, may vary. Future research should seek to identify contextual factors that support actualization of positive outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Peer support specialists (“peers”) who have the lived experience of, and are in recovery from, mental health challenges are increasingly being integrated into mental health care as a reimbursable service across the US. This study describes the ways peers were integrated into Help@Hand, a multi-site innovation project that engaged peers throughout efforts to develop and offer digital mental health interventions across counties/cities (“sites”) in California. Using a mixed methods design, we collected quantitative data via quarterly online surveys, and qualitative data via semi-annual semi-structured phone interviews with key informants from Help@Hand sites. Quantitative data were summarized as descriptive findings and qualitative data from interviews were analyzed using rapid qualitative analysis methods. In the final analytic phase, interview quotes were used to illustrate the complex realities underlying quantitative responses. 117 quarterly surveys and 46 semi-annual interviews were completed by key informants from 14 sites between September 2020 and January 2023. Peers were integrated across diverse activities for support and implementation of digital mental health interventions, including development of training and educational materials (78.6% of sites), community outreach (64.3%), technology testing (85.7%), technology piloting (90.9%), digital literacy training (71.4%), device distribution (63.6%), technical assistance (72.7%), and cross-site collaboration (66.7%). Peer-engaged activities shifted over time, reflecting project phases. Peer-provided digital literacy training and technology-related support were key ingredients for project implementations. This study indicates the wide range of ways peers can be integrated into digital mental health intervention implementations. Considering contextual readiness for peer integration may enhance their engagement into programmatic activities.

Peers are individuals with lived experience of mental health challenges trained to provide support to others with similar challenges. Help@Hand was a multi-site project that integrated peers into digital mental health intervention (DMHI) implementation. This study uses the Consolidated Framework for Implementation Research (CFIR) to frame challenges reported by peers when implementing DMHIs. Individuals leading the local peer workforce completed quarterly online surveys about perceived challenges to DMHI implementation. Biannual interviews probed for details on survey-reported challenges. 103 quarterly surveys and 39 bi-annual interviews were collected from key informants at 11 Help@Hand sites between Summer 2020 and Fall 2022. One challenge was tied directly to DMHIs; namely, device distribution. Several related to the Implementation Process, including challenges with recruiting qualified peers and integrating peers into DMHI implementations; communication and collaboration; and translation. Challenges in the Individual domain included unclear peer roles and multi-tasking across various projects. Inner Setting challenges included structural barriers to hiring peers, issues with communication and project management, and workforce turnover. Outer Setting challenges related to environmental technology readiness, COVID-19, unclear decision-making processes across the collaborative, and uneven communication between sites’ peers. Funding uncertainty bridged the Inner and Outer Settings. Using the CFIR model to frame challenges to DMHI implementation yielded useful lessons, especially when peers are engaged as partners in planning and implementation process. Successful implementation will be enhanced by ensuring adequate environmental readiness for tech-based interventions, clear role definition, streamlined peer hiring processes, and well-delineated lines of communication locally and across sites.

Cumulative adverse childhood experiences (ACEs) and psychological distress have been shown to negatively affect mental health across the lifespan. Less is known, however, about how ACEs might impact mental health help-seeking behavior in adulthood, especially among Asian Americans, a population with high exposure to trauma who also face cultural barriers to mental health care. The study’s aim was to evaluate the prevalence of ACEs within a sample of Asian American respondents, the relationship of ACEs and psychological distress with help-seeking, and the association of ACEs with different types of help-seeking behaviors. Data from the 2021 California Health Interview Survey (N = 4,345) were analyzed. Pairwise comparisons examined differences in ACEs and covariates across the seven Asian American subgroups (Chinese, Filipino, Japanese, Korean, Vietnamese, South Asian, and Other Asian American). Multivariable logistic regression analyses evaluated the relationship between ACEs and covariates with professional and emerging digital mental health help-seeking behaviors. The joint effect between ACEs and Asian American subgroup was evaluated for each type of mental health help-seeking. Covariates included psychological distress, gender, age, marital status, insurance, education, English proficiency, self-rated health, and being U.S.-born. Asian American adults with 4 + ACEs were more likely to seek mental health help from primary care practitioners, mental health professionals, and social media/blogs/online forums than respondents with ≤ 3 ACEs. Moderate/severe psychological distress increased likelihood to seek mental health help. No significant interaction between ACEs and Asian American subgroup was found. Findings indicate that Asian American respondents with elevated ACEs and distress are more likely to seek mental health help from professional and emerging digital resources. This suggests a demand for these resources among those with higher needs. Differences across ACEs and distress levels in help-seeking behaviors emphasize the need for culturally tailored interventions and accessible mental health resources to better support the diverse help-seeking preferences within the Asian American community.

BACKGROUND Disability is an increasingly prevalent issue in the United States, which affects over 67 million people. Poor mental health in individuals with disabilities is common; however, access to traditional modes of mental healthcare remains a challenge. OBJECTIVE This study aims to compare use of traditional and online mental healthcare services between people with and without disabilities. METHODS This study used a cross-sectional sample of adults aged 18 years and older (n=44,096) from the 2019-2020 California Health Interview Survey. Mental healthcare access in-person and online, or use of digital technologies for mental healthcare were compared between several disability groups to individuals without disabilities. RESULTS 15.3% of those in this sample reported being in one of the four reported disability groups: cognition, independent-living, seeing/hearing and self-care. All disability groups reported higher odds of accessing mental healthcare in-person compared to those without disabilities. Several disability groups had increased odds of accessing mental healthcare online, using online technologies for referrals to mental health professionals and connecting to others with a similar condition online. CONCLUSIONS People with disabilities readily access mental healthcare, in-person and online, and use technologies for broader mental healthcare needs. This study highlights the importance of centering accessibility within health technologies.