Attitudes Toward Seeking Mental Health Services and Mobile Technology to Support the Management of Depression Among Black American Women: Cross-Sectional Survey Study (Preprint)

Abstract

BACKGROUND Depression is a common mental health condition among Black American women. There are many factors that may contribute to development of depressive symptoms, such as gender and racial discrimination, financial strain, chronic health conditions, and caregiving responsibilities. Barriers such as stigmatization of mental illness, less access to treatment, lack of or inadequate health insurance, mistrust of providers, and limited health literacy prevent marginalized populations from seeking care. Prior literature has shown that mobile health interventions are effective and can increase access to mental health services and resources. OBJECTIVE This study aimed to understand the attitudes and perceptions of Black American women toward using mental health services and determine the acceptability and concerns of using mobile technology (i.e., voice call, video call, text messaging, and mobile application) to support management of depression. METHODS A self-administered web-based questionnaire was launched in October 2019 and closed in January 2020. Women (18 years or older) who identify as Black/African American (or multiracial, Black/African American and another race) were eligible to participate. The survey consisted of approximately 70 questions and included topics such as, attitudes toward seeking professional psychological help, acceptability of using a mobile phone to receive mental health care, and screening for depression. RESULTS The findings of the study (N=395) showed that younger Black American women were more likely to have greater severity of depression than their older counterparts. The results also revealed that Black American women have favorable views toward seeking mental health services. Respondents were most comfortable with the use of a voice call or video call to communicate with a professional to receive support to manage depression in comparison to text messaging or mobile app. The results revealed higher help-seeking propensity increases odds of indicating agreement with the use of voice calls and video calls to communicate with a professional to receive support to manage depression, by 27% and 38% respectively. However, no statistically significant odds ratios were found between help-seeking propensity and respondents' agreement to use mobile apps or text messaging. Moderate to severe depression severity increased odds of using mobile apps to communicate with a professional to receive support to manage depression by 43%. However, no statistically significant odds ratio existed between depression severity and respondents' agreement to use voice calls, text messaging, or video calls. Privacy and confidentiality, communication issues (e.g., misinterpreting text), and the impersonal feel of communicating by mobile phone (e.g., text messaging) were the primary concerns. CONCLUSIONS Black American women, in general, have favorable views toward seeking mental health services and were comfortable with the use of mobile technology to receive support to manage depression. Future work should address issues of access and consider preferences and cultural appropriateness of the resources provided.