Background:
COVID-19 shed light on a global mental health crisis and underscored a host of barriers to mental health support for historically marginalized groups. Critical among these barriers to care for those living in high income countries is an underrepresentation among mental health professionals. Evidence from the implementation of brief psychological interventions delivered by non-specialist providers offers a community-based pathway to expand the provision of representative mental health support. Problem Management Plus (PM+), a five-session intervention designed for adults affected by adversity and impaired by psychological distress, has demonstrated effectiveness in reducing distress in low-income countries and humanitarian context settings, but only recently has its feasibility and acceptability been explored when delivered remotely in high income countries, like the United States.

Methods:
In this single-arm feasibility trial, participants recruited from several sites in New York City (a university training clinic and two community-based organizations) were offered five sessions of PM+ delivered via Zoom. A mixed-methods design was used to assess the feasibility, acceptability, perceived utility, and impact of remotely delivered PM+. Data was collected via structured participant interviews at pre, post, and three-month follow-up and in-depth interviews were conducted with participants and providers. The primary clinical outcomes were depression symptoms assessed using the Patient Health Questionnaire (PHQ-9) and distress related to client-generated problems using the Psychological Outcomes Profile (PSYCHLOPS) administered at baseline and one-week post-intervention.

Results:
Quantitative and qualitative results of the 45 recruited participants demonstrated feasibility, acceptability and utility for non-specialist community providers delivering remote PM+ in NYC. Though the study was not powered to assess for effectiveness, improvement was demonstrated in both primary outcomes.

Conclusion:
Remote PM+ was acceptable to participants, and both participants and providers found it beneficial. A fully powered cluster randomized controlled trial is now being conducted to determine the effectiveness of PM+ in NYC.