Expanding the Reach of BRIDGE Training: Positioning Non-Mental Health Professionals to Bridge the Mental Health Treatment Gap

INTRODUCTION: Mental disorders account for the largest and fastest-growing category of disease burden in Croatia. Despite great need, individuals in Croatia with mental disorders rarely seek help, with only approximately 6% of females and 5% of males over the age of 15 with mental health conditions seeking formal treatment from a mental health professional. Alternative approaches to mental health service provision that do not rely on formal systems of care and trained mental health specialists are necessary to support at-risk populations. We previously introduced BRIDGE (Building Resilience through Information, Dialogue, Guidance, and Empowerment) Training as an evidence-based model for enhancing the uptake of mental healthcare services for hard-to-reach populations, with a special focus on women asylum seekers. In this pilot study, we examine the effectiveness of implementing the BRIDGE model with social work professionals who work with disadvantaged youth and migrant populations in a non-mental health capacity to increase access to and utilization of mental health support. METHODS: Recruitment was conducted through an academic partnership between the study PIs home institution and the school of social work at the local University in Osijek. Convenience sampling was used. A total of 14 social workers and social work students participated in the training series, completing all modules and providing pre- and post-training data. Pre- and post-training ratings for each of the 2 subscales as well as the total scale were compared using paired t-tests. Conventional content analysis was used to analyze qualitative data from the open-ended questions. RESULTS: All participants rated being “extremely” satisfied with the training (100%) and rated the training as helpful (100%). In terms of whether the training met their expectations, 97% responded as “extremely” and 3% responded as “very much”. The top 3 most frequently reported learning outcomes were: 1) evidence-based self-care strategies for supporting well-being, identified by 90% of trainees, 2) how to effectively communicate with people in distress to reduce stigma and encourage engagement in care, identified by 80% of trainees, and 3) how to differentiate between mental health conditions, identified by 70% of trainees. Results of the paired-samples t-tests indicate significant (p=<.001) improvements from pre-training to post-training across both outcomes of knowledge and ability, as well as for total scores. Participants improved by an average of 10 points on the knowledge subscale. The average increase on the ability subscale was 9 points. The mean increase in total score was 19 points and the effect size was substantial (Cohen’s d = 3.60), providing strong preliminary evidence that the training resulted in extensive overall improvement in knowledge and ability. CONCLUSION: BRIDGE Training is an evidence-based, community-driven program that is easily implemented in a brief timeframe and without requiring extensive resources. It has the potential to increase the availability of personnel equipped to identify and respond to those in need of mental health support who are unlikely to access formal mental healthcare services. Future studies should examine whether the acquired skill and knowledge of BRDIGE training translates into real-world behavior changes and improved client outcomes and with other groups of providers and vulnerable populations.