兰德-图书馆作为扩大心理健康支持的社区中心-健康图书馆倡议（L4H）（英）

There Is a Significant Need for Enhanced Mental Health Services in Rural TexasLike residents in rural communities across the United States, those in the rural areas of Texas face significant barriers to mental health care. Yet the need in rural Texas is particularly urgent: In 2022, the suicide rate in those areas was 20.88 suicides per 100,000 residents, nearly double the rate of 13.83 suicides in the metropolitan communities of Texas. Although rural communities may lack access to mental health providers, they have robust community libraries: trusted hubs that could be transformed, with adequate resources and supports, as a new access point for care. Using lay mental health workers, such as peer specialists, can be an innovative solution to tackle the well-documented shortage of mental health providers both regionally and nationally. R E S E A R C H B R I E FLibraries as Community Hubs for Expanding Mental Health SupportsLibraries for Health Initiative (L4H) Libraries May Be Part of the SolutionIn January 2022, St. David’s Foundation, an organization focused on advancing health equity in Central Texas, launched the Libraries for Health pilot to address the shortage of mental health care in rural Central Texas. RAND served as the pilot’s design and evaluation partner and worked alongside Via Hope, the pilot implementation partner that hired, trained, and supervised the peer specialists (described below). What Is Libraries for Health? Libraries for Health is a pilot initiative to bolster community mental wellness in Central Texas. It integrated mental health supports (i.e., mental health–focused resources, practices, relationships, and services) into ten rural libraries. The pilot began in 2022 and continued through 2025, while the formal evaluation concluded in 2024. Libraries for Health consisted of three primary components: Peer specialists: Libraries were assigned a trained peer specialist who, when possible, represented the communities they served. Peer specialists are individuals with lived experience of mental health challenges who use their training and experience to support others. Since 2019, Texas has been certifying peer specialists. Certification requires at least 40 hours of training and 250 hours of supervised work experience. Peer specialists supported the mental health needs of community members in the library through one-on-one and group interactions (see Figure 1).Individual patron supportLeading, planning, or attending eventsStaff support and coachingOther library dutiesFigure 1 Peer Specialist ActivitiesSOURCE: Features information from Libraries for Health peer specialist activity logs.2Library learning cohort: Libraries participated in a professional learning cohort that included quarterly meetings, professional learning, and other collaborative opportunities. Flexible grant funding: St. David’s Foundation awarded multi-year grants to libraries to support the implementation of pilot activities and the i