Community Health Workers are playing an increasingly vital role in mental health care, particularly in communities that have long been underserved by traditional systems. Working outside the bounds of formal clinical structures, they provide support grounded in shared experience, cultural understanding, and deep community trust.
A new review published in Harvard Review of Psychiatry examines the growing recognition of this workforce and calls for stronger investment in its future. The authors find that Community Health Workers are not only expanding access to care but helping to redefine what effective, equitable mental health support looks like. Their findings suggest that lasting improvements in mental health outcomes will depend not just on scaling services, but on shifting who is seen as a provider of care and a source of knowledge.
The article, Community Health Workers Research: Where Are We Now? A Narrative Review of an Expanding Workforce for Mental Health traces the evolution of CHWs and explores how this workforce can be better supported and integrated into mental health systems. Drawing on decades of research across six key domains (training, retention, integration, cost-effectiveness, impact measurement, and scalability), the authors present the case that CHWs are already transforming care, but long-term investment is needed to sustain their role.
“Though CHWs were largely consulted during the pandemic for general health care support in low- and middle-income countries, there is now recognition of the need to better partner with CHWs and realize their potential as a workforce contributing to mental health care,” the authors write.
Efforts to build more equitable mental health systems have increasingly focused on expanding roles for peer workers and community-based providers. Yet past research has highlighted deep tensions in how these roles are defined and supported. While peer specialists were originally envisioned as agents of mutual aid and advocacy, they are often tasked with enforcing clinical norms rather than challenging them. Others have documented how well-intentioned efforts at “inclusion” may reproduce marginalization when peer expertise is decontextualized, co-opted, or narrowly measured through biomedical outcomes.
At the same time, initiatives grounded in human rights and social determinants of health have shown the value of embedding care in local contexts and training lay workers in non-coercive, psychosocial approaches that reduce reliance on medication. These findings suggest that truly transformative care requires shifting not only who delivers mental health support, but also how systems recognize and share power with those closest to the communities they serve.
You've landed on a MIA journalism article that is funded by MIA supporters. To read the full article, sign up as a MIA Supporter. All active donors get full access to all MIA content, and free passes to all Mad in America events.
Current MIA supporters can log in below.(If you can't afford to support MIA in this way, email us at [email protected] and we will provide you with access to all donor-supported content.)
We don’t need researchers to tell us this though. Its common sense. Its sad how people act like this is rocket science and like it’s hard to understand. No one should even need to say this, people should already understand this intuitively. This is how much communities have fallen apart in this country. Most who work in the mental health field are truly ignorant and have no experience with medical care. They should not be working in those positions. They dont have the right experience and skills. Regardless though we have allowed these people to have way too much power and control over us. We can’t allow that anymore. We need to demand accountability from the government and medical system. Those who have harmed millions of people with abuse and neglect need to be held responsible.
Also many people don’t need “providers of care”. We can provide our own care if the government and medical system stops mistreating us and gives us the knowledge and tools to manage our own healthcare. Stop treating grown adults like children. Putting any of your needs healthcare or otherwise in the hands of another individual is always a terrible idea. Most of the time when a person relies on someone else to take care of their needs it ends badly. The majority of people can take care of themselves.
If the government and medical system would stop disabling and incapacitating millions of people with medical negligence and by prescribing harmful drugs like antidepressants and antipsychotics that would help a lot. They never will though. They make too much money. Our suffering is their gain. The more we suffer the more money they make. The entire system relies on people being sick and in pain and agony. If we had a society with healthy people in it there would be no need for all of this. We wouldn’t need all these hospitals, government buildings, schools, and other systems designed to enslave and control people. They want you to be a slave and they want to enslave your children into a life of servitude and debt. They want to subjugate us all and make us obey them. They don’t want us to be free or have any liberty to make our own choices in life.
A very sinister thing has happened in this country and around the world. Under the guide of medical care or mental health care they have taken away peoples human and constitutional rights. This will never stop until they are held accountable. The few rights we have left are being eroded everyday. It won’t be long now until we are complete slaves and have no freedom left in our lives. This seems to be the world people want though because few people protest or petition against the way things are. Those who speak out are abused and mistreated by the government and medical system. This needs to change. And the only way that will happen is when we actually start holding people responsible. In any other type of work if you hurt someone you get fired and face consequences. But the government and medical system are allowed to harm millions of people and face no consequences. it’s nothing but a sick and twisted joke and an insult to all of those who actually care about helping others and improving society
Report comment
Harvard university is a disgrace. They are the ones who started doing these immoral and unethical practices. Their methods were never outdated, they were always inhumane and barbaric to begin with. Thanks to these people humanity has entered into a second dark age. They are too selfish and arrogant to see or care about all the harm they are causing to individuals and society. They have set a terrible example by continuing to go along with these methods of social control and coercion. Instead of setting the right example they went along with this insanity.
They have helped to bring chaos and madness to our society. They are not heroes for doing this. They don’t even have common sense because all of this is obvious. You don’t need to research these things for years and spend millions of dollars doing that. In any other universe that would be considered fraud. Yet in this upside down world we live in these people are rewarded and praised. They are lavished with attention and recognition for pointing out something that one brain cell could understand. This is how much society has fallen apart. Our communities are broken and in despair.
We never should have listened to these people or let them have any influence over our lives. They are not heroes. They have helped to harm millions of people and they ignore the millions they are still harming. Their mental hospital is a joke. I have serious depression, ocd, anxiety, and other conditions and I said I didn’t want to take antidepressants or receive ECT. And because I said that my email was ignored. I was left to suffer and deal with this pain alone because I didn’t want my brain cells to be destroyed.
That’s how backwards this society is. That is not proper medical care. That is neglect. Leaving a person to suffer like this is beyond immoral and unethical. They are not a shining star in this galaxy, they are a back hole that devours all rational thought and reason. Their actions have helped to make this world a more terrible place. They should feel horrible for what they have done. Instead of showing empathy and understanding they only showed neglect and abuse. Prescribing antidepressants and antipsychotics to millions of people is harmful and not speaking out against this abuse is wrong. For decades they have allowed the government and medical system to harm millions of people. An unfathomable amount of damage has been done to people but yet the insanity is allowed to continue unchecked. What a nightmare. The have made this world more of a living hell than it already is.
Report comment