Our lab is constantly growing with our needs, interests, and personnel. Below is just a taste of what we're up to currently.
THE HOLISTIC OPPORTUNITY FOR EVERYONE INITIATIVE
Barriers to accessing mental health services are a root cause of poorer mental health outcomes among low-income individuals living in the U.S., with low-income mothers bearing much of this burden. Inability to access routine mental health screening, education, and culturally-competent treatment can elevate their vulnerability to depression, anxiety and other mental health disorders. Integrated care, the integration of behavioral health services into primary care, has been identified as a key approach to target this at-risk population and promote health equity.
In 2019 an academic-public health department partnership was formed to a) explore the value of integrated care in public health settings and b) to expand health service delivery in Mecklenburg County Public Health clinics to include behavioral health services and to better meet the mental health needs of low-income women. Known as the Holistic Opportunity Program for Everyone (H.O.P.E.) Initiative, we aim to holistically identify and address the physical, nutritional, and behavioral health needs of individuals in public health settings.
Listening Circles have been used across diverse communities for centuries as a means of holding space for one another and nurturing connections. These spaces are intended for sacred conversations – a place where individuals listen deeply to one another and where participants can attune to their inner voice. When these circles are held with hospitality, gratitude, and a conscious presence, they suspend perceived hierarchies, promote empathy instead of tolerance, and provide basic human needs for connection. Listening circles can be a vehicle for discovery, transformation, healing, peacemaking and community organizing.
In 2022 our lab moved into the listening circle domain, with the hope to explore how this approach may be scaled up as a cost-effective and cost-centered way to foster community healing. In the Fall of 2022, Dr. Scott piloted a systematic approach to implementation of listening circles among undergraduate students. The lab is currently identifying opportunities for program improvement and upscaling.
TECHNICAL ASSISTANCE ENGAGEMENT SCALE DEVELOPMENT
Technical Assistance (TA) is a capacity building strategy where experts or trained individuals in a particular area consult with an organization to provide targeted support and guidance on a specific organizational problem. It is widely used to support program or organizational implementation and other community development and improvement efforts. There is a lack of consensus in the field as it relates to both the definition and measurement of TA and its effectiveness, especially across different organizational contexts. To address this need, the lab has begun to develop the TA Engagement Scale.
The TA Engagement Scale is in the developmental stages and currently undergoing the Delphi consensus building process to gain expert consensus around the domains and items most important for TA engagement. The purpose of this scale is to assess the quality of engagement among TA providers and recipients. This scale is intended to be a formative evaluation tool used to facilitate conversation related to TA engagement and would be administered routinely to recipients.
YOUTH ACCESS TO PSYCHIATRY PROGRAM
With the support of federal HRSA funding, Dr. Scott is a primary investigator with the Youth Access to Psychiatry Program (YAP-P), an initiative to integrate adolescent-specific psychiatric services into primary care settings in the state of South Carolina. One key setting in which children receive primary care services is in school-based health centers (SBHCs). SBHCs are uniquely developed to address traditional access barriers by mitigating transportation and time constraints for families by providing services through the school directly to the children. This is why a key branch of YAPP is school-based YAP-P. School-based YAP-P is a South Carolina Department of Mental Health program which provides training and a provider-to-provider consultation line that connects pediatric primary care providers directly with a child & adolescent psychiatrist to support primary care providers’ management of patients with mental and behavioral health conditions.
As part of the school-based YAPP initiative, Dr. Scott and CWL team members are leading a statewide, SBHC inventory; needs and strengths assessment; and readiness assessment for select sites. Her team will also assist in the implementation and evaluation of the initiative in the selected pilot schools and use data to inform the specific training, technical assistance, and consultation needs of each SBHC. Subsequent stages will solicit stakeholder input about recommendations for expanding youth access to mental health services in school-based settings, anticipated barriers and pitfalls, and associated strategies for addressing anticipated challenges.