In a high-definition video module, a counselor named Donna walks down a street while describing methods of approaching patients who are experiencing mental health issues.
“[It] is a very sensitive issue, so it’s natural to feel a little uncomfortable asking questions about it,” she says. She reminds me that “it can save lives when we intervene or give advice to people in need”. Soothing music plays in the background and text appears on screen as Donna explains how to speak in a warm tone. She gives examples of indirect questions such as “How are you at home?” and “What is your relationship with your partner?”
In a few videos, Donna taught me how to be accepting, listen effectively, identify the signs of suicide, and connect patients with the right resources. This is Module 6 of EMPOWER, a program developed by the Mental Health for All Lab at Harvard Medical School.
The programme, which consists of a series of videos accompanied by short quizzes, is aimed at community health workers but is designed to give anyone working in areas lacking sufficient mental health resources the skills to identify and mitigate mental health issues in their community. EMPOWER has distilled psychological interventions into small chunks of simple-to-learn digitized lessons.
“This is not a replacement or alternative to specialty care, it is about extending the footprint of the mental health care system deep into the community,” says Founder Vikram H. Patel , Professor in the Department of Global Health and Community Medicine at HMS. .
Patel speaks quickly, less interested in explaining the details of the project than in tracing his larger mission; he’s someone who isn’t troubled by the minutiae that can overwhelm a big business, but instead looks toward what’s possible.
Trained as a clinical psychiatrist, Patel first identified a vast shortage of mental health clinicians while conducting research in Zimbabwe.
“I found that everything I had learned was impossible to apply because there were no mental health professionals,” he says. “It set me on the path to really questioning how one might engage and provide mental health care in these wildly different settings.”
Compared to traditional education, EMPOWER serves the cake without the icing, giving healthcare workers the skills to start making a difference quickly.
“The old-school model is how we teach you at Harvard: come spend a lot of time in person, with the expert, spend huge amounts of money,” says Patel. “That’s just not how community health worker training can progress.”
EMPOWER’s strength is its simplicity – it’s designed to be accessible to everyone, from frontline workers to nurses to everyday people. The team has completed trial implementation in Texas and India and plans to integrate feedback, add translations, create culture-specific scenarios, and design a skills assessment.
Early trial results show that community health workers are already benefiting from the program. “People come to see them and people trust them,” says Juliana L. Restivo, coordinator at Mental Health for All Lab. “By being trained with that, they’re actually equipped to know how to react.”
EMPOWER has gained traction in the global mental health arena, now counting partners like the CEO of the American Psychological Association on its advisory board as well as interdisciplinary researchers from Harvard and other universities.
Restivo said these partnerships set EMPOWER apart and “ensure that this work is not just another research project.”
Moving forward, says Patel, “the biggest challenges are actually systemic, funding.” But he is convinced that the funding will flow “when effective models are presented”.
Early EMPOWER modules so far have focused on core skills, depression management and early childhood intervention, with a more general curriculum in preparation for lay people like me.
I watch as Donna talks to patients in her office, nodding at the words of the other actors, clipboard in hand. She puts into practice the strategies that I have learned. And while I watch a very contrived scene play out and answer multiple-choice questions along the way, I can see myself using the lessons from these modules in my interactions with friends.
That’s Patel’s goal, that “anyone in the community can learn to support anyone else in the community,” he says. “There’s so much you can do in one encounter.”
— Magazine editor Dina R. Zeldin can be reached at [email protected]