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Using Digital Technologies to Improve Access to and Engagement with Mental Health Interventions by Marginalized Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 35957

Special Issue Editors

Dr. Yael Perry

E-Mail Website
Guest Editor
Telethon Kids Institute, University of Western Australia, Perth, Australia
Interests: digital mental health; youth mental health; eHealth; mHealth; prevention; marginalised populations; LGBTIQ mental health
Dr. Jennifer Nicholas

E-Mail Website
Guest Editor
Orygen, Victoria, Australia; The Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
Interests: digital mental health; youth mental health; functional recovery; mHealth; eHealth; self-management; early intervention
Dr. Kit Huckvale

E-Mail Website
Guest Editor
Black Dog Institute, University of New South Wales (UNSW), Sydney, Australia
Interests: eHealth; mHealth; digital phenotyping; digital mental health; mood disorders; prevention; quality and safety

Special Issue Information

Dear Colleagues,

Digital technology provides a myriad of new opportunities beyond traditional approaches to improve mental health through screening, assessment, monitoring and the development and delivery of interventions. To date, the literature has largely focused on applications of technology within and for the general population, with less attention paid to the specific needs of marginalized groups. Given the mental health disparities commonly experienced by marginalized populations, further research is warranted to ensure that digital technologies do not further disadvantage these groups and, indeed, to actively address their unique experiences and requirements.
The aim of this Special Issue is to present new insights, learning and grounded perspectives on how digital technologies can enhance access to and engagement with mental health interventions for marginalized groups.

We welcome rigorous research contributing to this aim, across a range of study designs. Specifically, the Special Issue aims to include research focused on (but not limited to) the following populations:

  • LGBTIQA+;
  • Seriously mentally ill;
  • First Nations;
  • Justice-involved people;
  • Refugees;
  • Any other group experiencing mental health disparities compared to the general population due to political, social, cultural or psychological factors.

We encourage submissions that offer pragmatic insights and/or recommendations for future public health practice and intervention development, including, but not limited to, user-centered studies, implementation research and cost-effectiveness analyses. Research syntheses that are aligned with the Special Issue’s theme and present a coherent view of the state of knowledge and opportunities for action regarding a particular community or intervention category are also welcomed. We also encourage submissions that take a cross-disciplinary and innovative approach, drawing on expertise from diverse fields, including digital health, public and mental health, information technology, computer science and the humanities.

Dr. Yael Perry
Dr. Jennifer Nicholas
Dr. Kit Huckvale
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital health
  • mental health
  • marginalized populations
  • minority populations
  • eHealth
  • mHealth
  • internet
  • access
  • engagement
  • promotion
  • prevention
  • treatment

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Published Papers (5 papers)

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Research

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23 pages, 2047 KiB  
Article
Strong and Deadly Futures: Co-Development of a Web-Based Wellbeing and Substance Use Prevention Program for Aboriginal and Torres Strait Islander and Non-Aboriginal Adolescents
by Mieke Snijder, Lexine Stapinski, James Ward, Briana Lees, Cath Chapman, Katrina Champion, Michael Doyle, Ian Watson, Rachael Sarra, Amanda Lear, Sophia Garlick Bock, Maree Teesson and Nicola Newton
Int. J. Environ. Res. Public Health 2021, 18(4), 2176; https://doi.org/10.3390/ijerph18042176 - 23 Feb 2021
Cited by 7 | Viewed by 5622
Abstract
School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures, a [...] Read more.
School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures, a six-lesson, curriculum-aligned wellbeing and substance use prevention program that was designed for, and with, the Aboriginal youth. Formative reviews and consultation recommended that the program (i) combine effective components of mainstream prevention with cultural elements, highlighting Aboriginal cultural strengths; (ii) avoid stigma and celebrates the cultural diversity by catering to both Aboriginal and non-Aboriginal students; and (iii) use digital technology to enhance engagement, implementation and scalability. Guided by an Appreciative Inquiry approach, the program was developed in partnership with an Indigenous Creative Design Agency, and four schools in New South Wales and Queensland, Australia. Aboriginal (n = 41) and non-Aboriginal students (n = 36) described their role models, positive aspects of their community and reasons to avoid substance use; these formed the basis of an illustrated story which conveyed the key learning outcomes. Feedback from teachers, students and content experts supported the acceptability of the program, which will be evaluated in a subsequent randomised controlled trial. Full article
(This article belongs to the Special Issue Using Digital Technologies to Improve Access to and Engagement with Mental Health Interventions by Marginalized Populations)
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17 pages, 405 KiB  
Article
AFFIRM Online: Utilising an Affirmative Cognitive–Behavioural Digital Intervention to Improve Mental Health, Access, and Engagement among LGBTQA+ Youth and Young Adults
by Shelley L. Craig, Vivian W. Y. Leung, Rachael Pascoe, Nelson Pang, Gio Iacono, Ashley Austin and Frank Dillon
Int. J. Environ. Res. Public Health 2021, 18(4), 1541; https://doi.org/10.3390/ijerph18041541 - 5 Feb 2021
Cited by 52 | Viewed by 9778
Abstract
Digital mental health interventions may enable access to care for LGBTQA+ youth and young adults that face significant threats to their wellbeing. This study describes the preliminary efficacy of AFFIRM Online, an eight-session manualised affirmative cognitive behavioural group intervention delivered synchronously. Participants (M [...] Read more.
Digital mental health interventions may enable access to care for LGBTQA+ youth and young adults that face significant threats to their wellbeing. This study describes the preliminary efficacy of AFFIRM Online, an eight-session manualised affirmative cognitive behavioural group intervention delivered synchronously. Participants (Mage = 21.17; SD = 4.52) had a range of sexual (e.g., queer, lesbian, pansexual) and gender (e.g., non-binary, transgender, cisgender woman) identities. Compared to a waitlist control (n = 50), AFFIRM Online participants (n = 46) experienced significantly reduced depression (b = −5.30, p = 0.005, d = 0.60) and improved appraisal of stress as a challenge (b = 0.51, p = 0.005, d = 0.60) and having the resources to meet those challenges (b = 0.27, p = 0.059, d = 0.39) as well active coping (b = 0.36, p = 0.012, d = 0.54), emotional support (b = 0.38, p = 0.017, d = 0.51), instrumental support (b = 0.58, p < 0.001, d = 0.77), positive framing (b = 0.34, p = 0.046, d = 0.42), and planning (b = 0.41, p = 0.024, d = 0.49). Participants reported high acceptability. This study highlights the potential of digital interventions to impact LGBTQA+ youth mental health and explores the feasibility of digital mental health to support access and engagement of youth with a range of identities and needs (e.g., pandemic, lack of transportation, rural locations). Findings have implications for the design and delivery of digital interventions for marginalised youth and young adults. Full article
(This article belongs to the Special Issue Using Digital Technologies to Improve Access to and Engagement with Mental Health Interventions by Marginalized Populations)
11 pages, 300 KiB  
Article
The Role of the Avatar in Gaming for Trans and Gender Diverse Young People
by Helen Morgan, Amanda O'Donovan, Renita Almeida, Ashleigh Lin and Yael Perry
Int. J. Environ. Res. Public Health 2020, 17(22), 8617; https://doi.org/10.3390/ijerph17228617 - 20 Nov 2020
Cited by 34 | Viewed by 5942
Abstract
A significant proportion of trans and gender diverse (TGD) young people report membership of the gaming community and resultant benefits to wellbeing. To date their experiences and needs regarding a key feature of games, the avatar, are largely unexplored, despite increasing interest in [...] Read more.
A significant proportion of trans and gender diverse (TGD) young people report membership of the gaming community and resultant benefits to wellbeing. To date their experiences and needs regarding a key feature of games, the avatar, are largely unexplored, despite increasing interest in the therapeutic role of avatars in the general population. The aim of this study was to better understand the role of the avatar in gaming, its impact on TGD young people’s mental health, and their unique needs regarding avatar design. N = 17 TGD young people aged 11–22 years (M = 16.3 years) participated in four focus groups. A general inductive approach was used to thematically analyze the transcribed data. TGD young people report considerable therapeutic benefits of using avatars with positive mental health implications. Importantly, TGD young people use avatars to explore, develop and rehearse their experienced gender identities, often as a precursor to coming out in the offline world. They also report negative experiences of feeling excluded due to the constraints of conventional notions of gender that are widely reflected in game design. Participants described simple design features to better reflect gender diversity, such as increased customization. Such changes would facilitate the positive gains reported by participants and better reflect the diversity of young people who use games. The findings have important implications for both recreational and serious or therapeutic game design. Full article
(This article belongs to the Special Issue Using Digital Technologies to Improve Access to and Engagement with Mental Health Interventions by Marginalized Populations)

Review

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14 pages, 346 KiB  
Review
Connection to... Addressing Digital Inequities in Supporting the Well-Being of Young Indigenous Australians in the Wake of COVID-19
by Roz Walker, Kim Usher, Debra Jackson, Corinne Reid, Katrina Hopkins, Carrington Shepherd, Reakeeta Smallwood and Rhonda Marriott
Int. J. Environ. Res. Public Health 2021, 18(4), 2141; https://doi.org/10.3390/ijerph18042141 - 22 Feb 2021
Cited by 26 | Viewed by 10168
Abstract
(1) Background: This article examines whether connection to digital technologies helps connect young Indigenous people in Australia to culture, community and country to support good mental health and well-being and protect against indirect and potentially long-term effects of COVID-19. (2) Method: We reviewed [...] Read more.
(1) Background: This article examines whether connection to digital technologies helps connect young Indigenous people in Australia to culture, community and country to support good mental health and well-being and protect against indirect and potentially long-term effects of COVID-19. (2) Method: We reviewed literature published between February and November 2020 and policy responses related to digital strategies. We searched PubMed, Google Scholar, government policy websites and key Indigenous literature sources, identifying 3460 articles. Of these, 30 articles and 26 policy documents were included and analysed to identify existing and expected mental health outcomes among Indigenous young people associated with COVID-19 and more broadly. (3) Results: There are inequities in affordable access to digital technologies. Only 63% of Indigenous people have access to internet at home. Digital technologies and social media contribute to strong cultural identity, enhance connections to community and country and improve mental health and social and emotional well-being outcomes. (4) Discussion: Access to digital technologies can facilitate healing and cultural continuity, self-determination and empowerment for young people to thrive, not just survive, in the future. (5) Conclusion: More targeted policies and funding is urgently needed to promote digital technologies to enhance Indigenous young people’s access to mental health and well-being services, maintain cultural connections and evaluate the effectiveness of these initiatives using Indigenous well-being indicators. Full article
(This article belongs to the Special Issue Using Digital Technologies to Improve Access to and Engagement with Mental Health Interventions by Marginalized Populations)

Other

Jump to: Research, Review

13 pages, 1188 KiB  
Study Protocol
IDTWO: A Protocol for a Randomised Controlled Trial of a Web-Based Mental Health Intervention for Australians with Intellectual Disability
by Peter A. Baldwin, Victoria Rasmussen, Julian N. Trollor, Jenna L. Zhao, Josephine Anderson, Helen Christensen and Katherine Boydell
Int. J. Environ. Res. Public Health 2021, 18(5), 2473; https://doi.org/10.3390/ijerph18052473 - 3 Mar 2021
Viewed by 3160
Abstract
People with intellectual disability (ID) experience higher rates of mental illness and reduced access to appropriate care and treatment. Tailored electronic mental health (eMH) programs offer opportunities to address these disparities. The aim of this study is to examine whether a fully automated [...] Read more.
People with intellectual disability (ID) experience higher rates of mental illness and reduced access to appropriate care and treatment. Tailored electronic mental health (eMH) programs offer opportunities to address these disparities. The aim of this study is to examine whether a fully automated and self-guided eMH program tailored to the needs of people with ID can reduce symptoms of anxiety and depression and improve daily functioning in people with borderline-to-mild ID. Australians with borderline-to-mild ID, aged 16 years and older with mild-to-moderate depression and/or anxiety symptoms will be eligible to participate with the help of a nominated carer, if necessary. A randomised controlled trial with a sample size of 150 participants divided into treatment and waitlist control arms will be conducted. Participants randomised to the intervention group will have full access to the Healthy Mind program for eight weeks. The waitlist control group will gain full access to the program following the eight-week treatment period. Efficacy will be assessed on the Anxiety, Depression, and Mood Scale; Kessler-10; and the World Health Organisation Disability Assessment Schedule 2.0 across three time-points (baseline, eight weeks, and three months). We expect that people who use the intervention will report reduced depression and anxiety, relative to the control group. To our knowledge, this is the first study to examine the effectiveness of a fully automated eMH program for improving mental health in people with ID. We expect our study to render new knowledge on the delivery and effects of internet-based cognitive behaviour therapy (CBT) tools for people with ID. Full article
(This article belongs to the Special Issue Using Digital Technologies to Improve Access to and Engagement with Mental Health Interventions by Marginalized Populations)
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