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

Abstract

Background Depression is a common mental health condition among Black American women. Many factors may contribute to the development of depressive symptoms, such as gender and racial discrimination, financial strain, chronic health conditions, and caregiving responsibilities. Barriers such as the stigmatization of mental illness, less access to treatment, the lack of or inadequate health insurance, mistrust of providers, and limited health literacy prevent marginalized populations from seeking care. Previous literature has shown that mobile health interventions are effective and can increase access to mental health services and resources. Objective We aimed to understand the attitudes and perceptions of Black women toward using mental health services and determine the acceptability and concerns of using mobile technology (ie, voice call, video call, SMS text messaging, and mobile app) to support the management of depression. Methods We launched a self-administered web-based questionnaire in October 2019 and closed it in January 2020. Women (aged ≥18 years) who identify as Black or African American or multiracial (defined as Black or 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, the acceptability of using a mobile phone to receive mental health care, and screening for depression. Results The findings (n=395) showed that younger Black women were more likely to have greater severity of depression than their older counterparts. The results also revealed that Black women have favorable views toward seeking mental health services. Respondents were the most comfortable with the use of voice calls or video calls to communicate with a professional to receive support for managing depression in comparison with SMS text messaging or mobile apps. The results revealed that higher help-seeking propensity increased the odds of indicating agreement with the use of voice calls and video calls to communicate with a professional to receive support for managing depression by 27% and 38%, respectively. However, no statistically significant odds ratios (all P>.05) were found between help-seeking propensity and respondents’ agreement to use mobile apps or SMS text messaging. Moderate to severe depression severity increased the odds of using mobile apps to communicate with a professional to receive support for managing depression by 43%; however, no statistically significant odds ratios existed for the other modalities. Privacy and confidentiality, communication issues (eg, misinterpreting text), and the impersonal feeling of communicating by mobile phone (eg, SMS text messaging) were the primary concerns. Conclusions Black American women, in general, have favorable views toward seeking mental health services and are comfortable with the use of mobile technology to receive support for managing depression. Future work should address the issues of access and consider the preferences and cultural appropriateness of the resources provided.

Black American women’s attitudes toward seeking mental health services and use of mobile technology to support the management of anxiety

“…The primary concerns were privacy and confidentiality, communication issues (eg, misinterpreting text), and the impersonal feeling of communicating by mobile phone (eg, SMS text messaging) with regard to using mobile technology to receive support. 44 …”

“…The self-administered web-based questionnaire was launched in October 2019 and closed in January 2020. 44 Women (18 years or older) who identify as Black/African American (or multiracial, Black/African American and another race) and reside within the United States were eligible to participate. Participants were recruited through convenience sampling.…”

Digital Health Tools Can Support Patient Access to Culturally and Linguistically Competent Behavioral Health Treatment

“…It, however, remains somewhat unclear just how much enthusiasm for digital health tools really exists, who will use them, and how they will fit among other traditional and innovative therapeutic modalities. Thus, it was interesting and important to read McCall et al's [1] research and conclusion that "Black American women, in general, have favorable views toward seeking mental health services and are comfortable with the use of mobile technology to receive support for managing depression." Their findings dovetail with other research showing that, while digital therapies are likely to be effective, equity, privacy, ethics, and reimbursement considerations must be part of the discussion as these therapies are being developed [2,3].…”

“…It, however, remains somewhat unclear just how much enthusiasm for digital health tools really exists, who will use them, and how they will fit among other traditional and innovative therapeutic modalities. Thus, it was interesting and important to read McCall et al’s [ 1 ] research and conclusion that “Black American women, in general, have favorable views toward seeking mental health services and are comfortable with the use of mobile technology to receive support for managing depression.”…”

“…The Substance Abuse and Mental Health Services Administration in a recent issue brief explored regulatory, research, and equity considerations associated with digital therapeutics, noting that future therapies “must be designed and implemented to account for differences in health and digital literacy and to be culturally and linguistically appropriate, adaptable to variable service settings, and affordable and accessible for all users” [ 2 ]. Research like that of McCall et al [ 1 ] helps providers, policy makers, and patients better understand how patients may perceive the benefits and drawbacks of digital health tools. As McCall et al [ 1 ] acknowledge, their research may not necessarily be broadly applicable to other populations, and additional understanding of how digital therapeutics are perceived across income levels, geographic areas, race and ethnicity, sexual orientation, and other demographic groups would be helpful.…”