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The Surgeon General of the United States in 2003 documented the existence of striking disparities for minorities and immigrants in mental health services and the underlying knowledge base. This thesis expands the knowledge base by examining the personal experiences and perspectives of community health workers (CHWs) employed in a mental health project. CHW interventions have been shown to increase access and reduce barriers to health care services. CHWs come from similar cultural and ethnic backgrounds as recipients of services and share similar life experiences. As cultural mediators between ethnic communities and a primary health care system, CHWs are able to provide valuable insight into immigrant mental health disparities. Through case study analysis, this thesis explores the personal experiences of CHWs employed by a grant-funded mental health project. Utilizing ethnographic research methods to better understand the CHW intervention, this thesis focuses on CHW motivations, their challenges and the impact of work on their personal lives. Results suggest that CHWs experienced many positive changes in their own lives as a result of their work. CHWs are better able to address their own physical and mental health needs. By increasing access to community and clinic services, CHWs help to improve the mental and physical health status of clients. Results suggest that the cultural competency of clinic staff, service providers and clients improved. CHWs help to strengthen community bonding or social capital by expanding social networks and empowering individuals to create change in their own lives. / Graduation date: 2006

The problem of this study was the identification of ways and means of reducing paraprofessional turnover in mental health and mental retardation facilities. The high turnover rate of mental health and mental retardation paraprofessionals has major implications for the quality and cost of client services. Several researchers have suggested that adequately trained supervisors can influence the turnover rate among employees as well as their motivation and production. A six-month study of the Texas Department of Mental Health and Mental Retardation released in March, 1980 by a blue ribbon audit team blamed bad management practices, not low pay and poor working conditions, for the high rate of employee turnover. However, few studies have investigated the effect of supervisory training on turnover and researchers have called for additional studies in the area. The purpose of this study was to employ two specific intervention techniques with supervisory personnel in order to determine their effectiveness in reducing the rate of paraprofessional employee turnover in mental health and mental retardation facilities.