We currently face a national crisis in youth mental health and well-being and significant child behavioral health inequities. Addressing social determinants is a primary approach to achieving health equity. Social determinants of mental health (SDoMH) impact every child across the mental health services continuum, with inequities driven by discrimination across social class, race, gender, sexual orientation, physical ability, national origin, intellectual or mental abilities, and other group categories and combinations of group categories. While clinician passion, ingenuity, and support for advancing SDoMH resources and social justice are crucial, navigating rapidly changing community resources and tailoring the strategies for individual patients can be daunting for clinical personnel who are already overwhelmed with clinical loads. We build upon Cotton and Shim's (2022) call to action for clinicians to meet SDoMH needs across the public health framework/pyramid. A complementary approach builds upon this traditional clinician-driven model to a community team model. It adds a new team member, the community health worker (CHW). CHWs bring deep community ties, community relationships, and trust to support family-driven priorities around unmet SDoMH needs. They help families navigate the evolving local resources, contacts, and processes to meet SDoMH needs as well as social change. We share community team examples across geographies (urban and rural), settings (clinics, schools, churches), and clinical service delivery (traditional in-person and telehealth) aimed at improving child biopsychosocial outcomes.

中文翻译：

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社区卫生工作者：通往儿科心理健康公平的桥梁


我们目前面临青少年心理健康和福祉的全国性危机以及严重的儿童行为健康不平等问题。解决社会决定因素是实现健康公平的主要方法。心理健康的社会决定因素 (SDoMH) 影响着整个心理健康服务体系中的每个儿童，社会阶层、种族、性别、性取向、身体能力、国籍、智力或心理能力以及其他群体类别之间的歧视造成了不平等，组类别的组合。虽然临床医生的热情、独创性以及对推进 SDoMH 资源和社会正义的支持至关重要，但对于已经不堪重负的临床工作量的临床人员来说，驾驭快速变化的社区资源并为个体患者制定策略可能会令人望而生畏。我们以 Cotton 和 Shim (2022) 呼吁临床医生采取行动来满足整个公共卫生框架/金字塔中的 SDoMH 需求为基础。一种补充方法建立在这种传统的临床医生驱动模型和社区团队模型的基础上。它增加了一名新的团队成员，即社区卫生工作者 (CHW)。 CHW 带来深厚的社区联系、社区关系和信任，以支持围绕未满足的 SDoMH 需求的家庭驱动的优先事项。他们帮助家庭掌握不断变化的当地资源、联系和流程，以满足 SDoMH 的需求和社会变革。我们分享跨地域（城市和农村）、环境（诊所、学校、教堂）和临床服务提供（传统的面对面和远程医疗）的社区团队示例，旨在改善儿童的生物心理社会结果。