Her research aims to increase access to mental health services
Accessing mental health services for families with children who have behavioral disorders is time-consuming and, for many, overwhelming. Moreover, there are not enough practitioners to meet the needs of families in poverty-impacted communities where such conditions as violence and housing inequality increase the risk for children to develop mental health problems. Additionally a reluctance to pursue help in clinical settings because of stigma, adds to the large gap between families who need counseling services and families who are receiving them.
Enter University of Maryland School of Social Work, Assistant Professor, Geetha Gopalan, who, since her days as a social worker in therapeutic foster care and emergency room psychiatric evaluation, has been dedicated to increasing access to mental health services for families.
These prior clinical experiences highlighted how vulnerable families have complex, co-occurring needs that often span both child welfare and mental health service systems.
The ultimate goal with this research and future studies, says Gopalan, is to innovate how and where interventions are delivered. In doing so, this research provides added knowledge regarding how to improve the ability for families to access effective mental health treatment, as well as for service systems to, potentially, reduce costs. “It’s time,” she adds, “to think outside the box of mental health interventions in mental health settings.”
However, given the challenges with accessing mental health services, unmet child mental health needs can often lead to costly emergency room visits and restrictive levels of care due to psychiatric crises. One way she is working toward improving access to evidence-based mental health interventions is exploring alternate settings where families could access them, such as child welfare services, and researching how some interventions historically provided by highly credentialed mental health professionals could be “task-shifted” to people without advanced qualifications.
Gopalan is principal investigator on a study funded by the National Institute of Mental Health through which she is implementing a parent training program to reduce child behavioral difficulties, delivered by child welfare case workers. She believes that with training, supervision, and a manualized curriculum, folks within the helping professions who aren’t clinicians can successfully guide groups through the program’s content. By using the child welfare system as a non-specialty service sector platform to launch targeted mental health services, this study aims to understating how facilitate cross-setting implementation for similar evidence-based practices. Moreover, task shifting provides an innovative way to increase mental health treatment access and reduce costs within transforming child-serving systems.
“That doesn’t mean that all interventions should be open to task-shifting, but I think there’s a lot to learn about how to shift responsibilities to non-clinicians,” says Gopalan. “That’s what this study is seeking to understand—what are the challenges of doing that?”
The program runs via the Anne Arundel County, Md., Department of Social Services instead of through mental health channels. In most cases, Child Protective Services have identified the school-age children participating in the program who have behavioral disorders, as being at-risk for maltreatment.
Each week, multiple families meet, not at a clinic but in a spacious room in a county courthouse. The multigenerational group enjoys a hot meal and is exposed to evidence-based strategies for strengthening families. Topics include respectful communication, rules, responsibilities, relationships, social support, and stress reduction. Additionally, the families gain support from each other who have been through similar experiences.
“We’re creating a space for people to come and meet other families like them, so that they don’t necessarily feel alone, says Gopalan. “I think that’s pretty powerful.”
Gopalan and her research team attend the gatherings to supervise and collect data on how the case workers are delivering the content. The researchers also are using surveys and interviews with various stakeholders to get information that will help determine the program’s feasibility and acceptability.