Integrating psychosocial clinical interventions (CIs) into social service settings (CBOs) is one strategy for reaching linguistically diverse communities of color who have been systematically excluded from mental health care due to racism, poverty, and other structural inequities. Our recent research and practice suggests CBO-embedded CIs can improve reach while maintaining fidelity, however usability issues persist which limits equitable and sustainable CI adoption. We have identified several CI usability challenges (e.g., incompatibility of one-CI-at-a-time with organizational workflows that provide multifaceted, multigenerational care; complex CIs hinder cultural and linguistic adaptations) as well as usability facilitators (e.g., CI training builds capacity among bilingual, bicultural providers; community-academic partnerships can plan quality adaptations). Anti-racist implementation science calls for changing how we partner on research lest we perpetuate inequities our field is working to solve. A successful PEARLS partnership with Neighborhood House (a King County CBO that serves 40 languages) offers an opportunity to apply Discover, Design/Build, Test (DDBT) using anti-racist approaches. The project featured a co-design process led by Somali community leaders and CBO staff to adapt the World Health Organization’s mental health program, Problem Management Plus (PM+). The adapted PM+ incorporates Somali and Islamic values and is the product of shared decision-making. The project is evaluating the adapted PM+ in 2025-2026 with funds from UW’s Population Health Initiative. 

Despite the impact of depression, anxiety, stress, trauma, isolation, and other mental health challenges—and the existence of effective care models—a significant treatment gap remains for the 1 in 5 U.S adults living with mental health conditions, 80% of which do not receive minimally adequate care. Poor access to care is fueled by a shortage of mental health workers especially bilingual and bicultural providers, stigma about care, and upstream social determinants of mental health. Integrating mental health care into social services can reduce mental health disparities. Adaptations are increasingly seen as not only essential for successful intervention delivery, but as an implementation strategy for health equity, with community-academic partnerships planning proactive adaptations can improve usability for linguistically diverse communities. The project is an example of centering resilient communities in leading the process for identifying, adapting, and delivering mental health interventions to improve intervention usability.