The floods and devastation of Hurricanes Katrina and Rita contributed to socioeconomic instability and psychosocial trauma for the affected communities and populations, significantly for people of limited economic means and persons of color. Though more than 1/3 of the adult population from impacted areas experienced significant psychological distress, few people had access to or received appropriate health or mental health services in the months and years that followed. Community health workers (CHWs)—defined as lay community members whose backgrounds are similar to those for whom they provide such services as culturally relevant health education, individual- and community-level advocacy, and links to the health care system— may represent a particularly promising workforce strategy to increase access to quality mental health services and overcome racial and ethnic disparities in care. In this paper, we briefly review a post-disaster mental health training program for CHWs from the greater New Orleans area. We present preliminary evidence that CHWs remain engaged in addressing post-disaster concerns, and that there is community support for further CHW education. We discuss implications for CHW participation in recovery from future disasters and we highlight the work of Cynthia Carriere, a CHW from the Lower 9th Ward in New Orleans.
BrookR.Medical leadership in an increasingly complex world.JAMA.2010; 304(4): 465–6.
2.
CatalaniC., VenezialeA., HerbstS., CampbellC., ButlerB., SpringgateB., MinklerM.Videovoice: community assessment in post-Katrina New Orleans.Health Promot Pract. (In press).
3.
CollinsJ.A., CavanaughM.The paraprofessional II brief mental health training for the community health worker.Hosp Community Psychiatry.1971; 22: 367–70.
4.
CorkeryE., PalmerC., FoleyM., SchecterC., FrisherL., RomanS.Effect of a bicultural community health worker on completion of diabetes education in a Hispanic population.Diab Care.1997; 20(3): 254–7.
5.
CohenJ.A., JaycoxL.H., WalkerD.W., MannarinoA.P., LangleyA.K., DuClosJ.L.Treating traumatized children after Hurricane Katrina: project fleur-de lis.Clin Child Fam Psychol Rev.2009; 12(1): 55–64.
6.
DixonL., StewartB., KraussN., RobbinsJ., HackmanA., LehmanA.The participation of families of homeless persons with severe mental illness in an outreach intervention.Community Ment Health J.1998; 3: 251–9.
7.
ElderJ., AyalaG., CampbellN., SlymenD., Lopez-MadurgaE., EngelbergM.Interpersonal and print nutrition communication for a Spanish-dominant Latino population: Secretos de la buena vida.Health Psychol.2005; 24(1): 49–57.
8.
GilliamM., FischbachS., WolfL., AzikiweN., TegelerP.Rebuilding a healthy New Orleans: the New Orleans health disparities initiative.2007.
9.
HansenL., FeiglP., ModianoM., LopezJ., Escobedo SluderS., MoinpourC.An educational program to increase cervical and breast cancer screening in Hispanic women: a Southwest oncology group study.Cancer Nurs.2005; 28(1): 47–53.
10.
HunterJ., de ZapienJ., PapenfussM., FernandezM., MeisterJ., GiulianoA.The impact of a promotora on increasing routine chronic disease prevention among women aged 40 and older at the U.S.-Mexico border.Health Educ Behav.2004; 31(4 Suppl): 18S–28S.
11.
JonesL., WellsK.Strategies for academic and clinician engagement in community-Participatory Partnered Research.JAMA.2007; 297(4): 407–10.
12.
HenryJ. Kaiser Family Foundation. Local contributors: DeSalvo K, Springgate B, Williams C, Bergson S, Stone G, Cerise F. Health challenges for the people of New Orleans: the Kaiser post-Katrina baseline survey.2007. Available at http://www.kff.org/kaiserpolls/upload/7631.pdf. Accessed 19 August 2010.
13.
KataokaS.H., NadeemE., WongM., LangleyA.K., JaycoxL.H., SteinB.D.Improving disaster mental health care in schools: a community-partnered approach.Am J Prev Med.2009; 37 Suppl 1: S225–9.
14.
KesslerR.C., GaleaS., JonesR.T., ParkerH.A.Mental illness and suicidality after Hurricane Katrina.Bull World Health Organ.2006; 84(12): 930–9.
Media Newswire.Conference highlights mental health care progress in post-Katrina New Orleans.2009. Available at: http://media-newswire.com/release_1097994.html. Accessed 23 August 2010.
17.
NavarroA., SennK., McNicholasL., KaplanR., RoppeB., CampoM.Por La Vida model intervention enhances use of cancer screening tests among Latinas.Am J Prev Med.1998; 15(1): 32–41.
RichardsD., BradshawT., MarisH.Helping people with mental illness: a mental health training programme for community health workers.2003. Available at: http://www.who.int/mental_health/policy/en/Module%20A.pdf. Accessed 1 February 2010.
22.
RoyN., ShahH., PatelV., BagalkoteH.Surgical and psychosocial outcomes in the rural injured—a follow-up study of the 2001 earthquake victims.Injury.2005; 36: 927–34.
23.
SastryN., VanlandinghamM.One year later: mental illness prevalence and disparities among New Orleans residents displaced by Hurricane Katrina.Am J Public Health.2009; 99(S3): S725–31.
24.
SchoenbaumM., ButlerB., KataokaS., NorquistG., SpringgateB., SullivanG.Promoting mental health recovery after hurricanes Katrina and Rita.Arch Gen Psychiatry.2009; 66(8): 906–14.
25.
SpringgateB., AllenC., JonesC., LoveraS., MeyersD., CampbellL.Community-based participatory assessment of health care needs in post-Katrina New Orleans. In: GilliamM., FischbachS., WolfL., AzikiweN., TegelerP., editors. Rebuilding a healthy New Orleans. Final conference report of the New Orleans health disparities initiative. Poverty and Race Research Action Council.2007. Available at: http://www.prrac.org/pdf/rebuild_healthy_nola.pdf. Accessed 23 August 2010.
26.
SpringgateB., DunnD.Medical homes, integrated care, and the role of behavioral health.Dialogues on Behavioral Healthcare. New Orleans, LA. November 11, 2009.
27.
SpringgateB., AllenC., JonesC., LoveraS., MeyersD., CampbellL.A rapid community participatory assessment of healthcare access in post-Katrina New Orleans.Am J Prev Med.2009; 37(6S1): S237–43.
28.
United States Department of Health and Human Services.Health Resources and Services Administration.Community health workers national workforce study.2007. Available at: http://bhpr.hrsa.gov/healthworkforce/chw/. Accessed 19 August 2010.
29.
VoelkerR.Memories of Katrina continue to hinder mental health recovery in New Orleans.JAMA.2010; 304(8): 841–3.
30.
WangP.S., GruberM.J., PowersR.E., SchoenbaumM., SpeierA.H., WellsK.B.Mental health service use among Hurricane Katrina survivors in the eight months after the disaster.Psychiatr Serv.2007; 58(11): 1403–11.
31.
YunK., LurieN., HydeP.S.Moving mental health into the disaster preparedness spotlight.N Engl J Med.2010. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMp1008304. Accessed 26 August 2010.
