Using a Little Free Library to Improve Access to Mental Health and Wellness Resources at a Primary Care Clinic

THE INNOVATION

Mental health disorders and suicide rates have steadily increased over the past 20 years, with rural areas experiencing the greatest increases.¹ These regions face significant challenges, including limited access to mental health services and economic hardship. We wanted to increase access to mental health resources for adult patients with mental health disorders.

WHO & WHERE

A Little Free Library (LFL) was placed outside a rural primary care clinic and stocked with mental health books and resources for adult patients with a variety of conditions, including anxiety, depression, post-traumatic stress disorder (PTSD), etc.

HOW

Using the expertise of a community psychiatrist, psychologist, and community partners who support patients with mental health disorders, we chose a variety of mental health books and workbooks that address common mental health conditions. We placed the LFL near the entrance to our clinic and near the clinic’s community garden. It is available for all who are interested in using it (it is not a requirement to be a patient). At all times, the LFL is stocked with about 10-15 books. Additionally, a flyer with a QR code attached to the LFL directs patients to a community-run webpage that contains a plethora of community mental health resources for anyone to use.

If participants choose to take a book, they are asked to complete a survey to understand the demographics, referral source, and usefulness of the resources in the LFL. The survey is accessed through a QR code adhered to each book that links to an anonymous Qualtrics (Silver Lake Technology Management, LLC) survey. The survey also asks if participants sought out additional mental health care.

The number of books taken or exchanged will be reviewed weekly, and a counter on the library door will track how often the library door is opened. This will help assess the feasibility and appeal of the LFL concept, as well as identify the most frequently used resources. Clinicians at the clinic are informed of the availability of the resources, and they will be surveyed on their experiences referring patients to the LFL.

See Supplemental Figures 1-4 for images of the library and magnetic counter.

LEARNING

We have been able to increase access to mental health books and resources for our patients and the community by placing an LFL outside our primary care clinic, and we are in the process of studying the utility and impact of this intervention. This is a low-cost, patient-centered, and community-informed approach to improving access to mental health care and is easily scalable to other primary care and community sites.