Increasing Mental Health Literacy and Decreasing Stigma with the Lay Mental Health Advocates (LMHA) Program

Purpose: Historically, mental health stigma, access to care, and discrimination all contribute to worsened health outcomes, especially for minority populations. To help address this, the Lay Mental Health Advocates (LMHA) program was created. This free, virtual training program is designed to teach laypersons the fundamentals needed to advocate for someone who is dealing with mental illness and their family members. LMHA focuses on teaching mental health advocacy by understanding how social determinants of health and racism play a key role in worsening mental health outcomes for marginalized communities. Workshops are led by psychiatry resident/attending physicians from Duke University Hospital and local community leaders. They include interactive role-playing advocacy practice, case study reviews, and other informative components. Those who complete at least 80% of the 8-week course material receive a certificate of completion and are eligible to apply to become an advocate through the LMHA volunteer network. Methods: LMHA began as a volunteer project of the National Institutes of Health Academy Fellows, a program that gives trainee scientists the opportunity to implement a volunteer health program that addresses health disparities in their local community. The pilot LMHA program took place in Spring 2021. Pre and post program surveys were distributed to all active participants. The 2021 program had 100 participants (ages 18-58). 77 of these earned certificates of completion. The revamped 2022 program is on track to have double the number of participants from across the country. The curriculum was created by modeling the Johns Hopkin's Medicine Lay Health Advocate Program and the Mental Health Allyship Program. Needs assessment surveys were analyzed for the DC, Baltimore, and Durham regions to model the program on the community's needs. 3 sets of focus groups were conducted throughout the pilot program to further the curriculum and gain the participant's insight. Results: Comparing pre and post program survey data, there were increases in participant's: 1. Level of comfort using skills learned with LMHA to serve as an advocate for someone, 2. Understanding of how racism can impact a person's mental health and access to mental healthcare, 3. Understanding of how social determinants of health can affect someone's mental health and access to mental health resources, and 4. Desire to become a mental health professional. Conclusions: There is a need for interventional programs to fill the mental health gap that is particularly prevalent among marginalized communities. Through LMHA, advocates can identify several different mental disorders, gain a greater understanding of the factors that exacerbate health disparities, understand how to provide effective emotional support, and gain confidence in the role they can play in affecting people in their community by being a mental health advocate.