COVID-19 and Mental Health Care Delivery: A Digital Divide Exists for Youth With Inadequate Access to the Internet

Smith-East, Marie; Starks, Shaquita

doi:10.1016/j.jaac.2021.04.006

Cited by 14 publications

(8 citation statements)

References 2 publications

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“…Fortunately, solutions like the Psychological Interjurisdictional Compact (PSYPACT), which has been enacted in just over half of the United States, holds promise in reducing these barriers to care through rapid expansion. Additionally, despite the prevalence of smartphones and internet-connected computers, limitations in reliable internet access for many children remains a significant structural and systemic barrier to care [ 111 , 112 ]. Public policy changes, like the Affordable Connectivity Program [ 113 ], are required to make reliable internet access more equitable and reduce coverage and licensure barriers to this care.…”

Section: Discussionmentioning

confidence: 99%

Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis

Stone

Elkins

Gardner

et al. 2023

Child Psychiatry Hum Dev

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Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic ( n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.

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Section: Discussionmentioning

confidence: 99%

Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis

Stone

Elkins

Gardner

et al. 2023

Child Psychiatry Hum Dev

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“…Although smartphones can also be used to access the internet, and indeed many youth use smartphones, there are recognized limits to having only smartphone internet access [ 24 , 38 ]. Our finding that in 2017, 3%-5% of youth accessed the internet only from smartphones, suggests that some youth will experience challenges (eg, with connectivity and poor audio and video) [ 17 , 24 , 38 ]. The disadvantages of smartphone-only access will have a greater impact on Black and Hispanic youth living in low- and middle-income households.…”

Section: Discussionmentioning

confidence: 99%

“…Home access may have advantages over community access (eg, school and library) for youth seeking health-related information or assistance on sensitive topics (eg, sexual health and mental health; see the study by Smith-East [ 17 ]). For example, with rare exceptions, sexual content is blocked on school computers (see the study by Dolcini et al [ 4 ]), and community sites may not offer adequate privacy for health consultations [ 17 ]. Regardless of these limitations, community internet access follows similar patterns as home access, such that low-income youth have lower access than high-income youth [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given that health-related conditions (eg, obesity, diabetes, and sexually transmitted infections) disproportionately impact low-income and racial and ethnic minority youth [14][15][16], access may be particularly important for these groups. Those with intermittent, limited, or no access to the internet will be disadvantaged because their ability to benefit from web-based health-related resources and programs, job searches, and educational activities will be lower than among those who have stable internet access [17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

National-Level Disparities in Internet Access Among Low-Income and Black and Hispanic Youth: Current Population Survey

Dolcini¹,

Canchola²,

Catania³

et al. 2021

J Med Internet Res

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Background Internet access is increasingly critical for adolescents with regard to obtaining health information and resources, participating in web-based health promotion, and communicating with health practitioners. However, past work demonstrates that access is not uniform among youth in the United States, with lower access found among groups with higher health-related needs. Population-level data yield important insights about access and internet use in the United States. Objective The aim of this study is to examine internet access and mode of access by social class and race and ethnicity among youth (aged 14-17 years) in the United States. Methods Using the Current Population Survey, we examined internet access, cell phone or smartphone access, and modes of connecting to the internet for adolescents in 2015 (unweighted N=6950; expanded weights N=17,103,547) and 2017 (unweighted N=6761; expanded weights N=17,379,728). Results Internet access increased from 2015 to 2017, but socioeconomic status (SES) and racial and ethnic disparities remained. In 2017, the greatest disparities were found for youth in low-income households (no home access=23%) and for Black youth (no home access=18%) and Hispanic youth (no home access=14%). Low-income Black and Hispanic youth were the most likely to lack home internet access (no home access, low SES Black youth=29%; low SES Hispanic youth=21%). The mode of access (eg, from home and smartphone) and smartphone-only analyses also revealed disparities. Conclusions Without internet access, web-based dissemination of information, health promotion, and health care will not reach a significant segment of youth. Currently, SES and racial and ethnic disparities in access prolong health inequalities. Moreover, the economic impact of COVID-19 on Black, Hispanic, and low-income communities may lead to losses in internet access for youth that will further exacerbate disparities.

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“…Accessibility via devices, such as smartphones and high-speed Internet, and technological literacy were noted as challenges facing Asian Pacific children and youth [73]. Significant subgroups of American youth (particularly those who live in low-income and rural areas) are also experiencing marginalization because of inadequate access to the Internet, resulting in a gap during COVID-19 which is widening pediatric mental health differences [76]. Stigmatizing attitudes, accessibility, and affordability issues are experienced by Australian youth in non-urban areas, resulting in higher self-harm, suicidal ideation, and suicide attempt rates [75].…”

Section: Digital Mental Health For Young Peoplementioning

confidence: 99%

Digital Mental Health Amid COVID-19

Balcombe

Leo

2021

Encyclopedia

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Digital Mental Health is information and communication technology used in mental health services delivered or boosted through the Internet and related technologies, smartphone and wearable technologies as well as immersive solutions (e.g., Virtual Reality and video games). It is predominantly used as self-help services or with the assistance of a (para-)professional and/or artificial intelligence for the provision of mental health promotion as well as mental ill-health identification, prevention and intervention.

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COVID-19 and Mental Health Care Delivery: A Digital Divide Exists for Youth With Inadequate Access to the Internet

Cited by 14 publications

References 2 publications

Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis

Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis

National-Level Disparities in Internet Access Among Low-Income and Black and Hispanic Youth: Current Population Survey

Digital Mental Health Amid COVID-19

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