Diversity, equity and inclusion considerations in mental health apps for young people: protocol for a scoping review

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Abstract

Introduction

After COVID-19, a global mental health crisis affects young people, with one in five youth experiencing mental health problems worldwide. Delivering mental health interventions via mobile devices is a promising strategy to address the treatment gap. Mental health apps are effective for adolescent and young adult samples, but face challenges such as low real-world reach and under-representation of minoritised youth. To increase digital health uptake, including among minoritised youth, there is a need for diversity, equity and inclusion (DEI) considerations in the development and evaluation of mental health apps. How well DEI is integrated into youth mental health apps has not been comprehensively assessed. This scoping review aims to examine to what extent DEI considerations are integrated into the design and evaluation of youth mental health apps and report on youth, caregiver and other stakeholder involvement.

Methods and analysis

We will identify studies published in English from 2009 to 29 September 2023 on apps for mental health in youth. We will use PubMed, Global Health, APA PsycINFO, SCOPUS, CINAHL PLUS and the Cochrane Database and will report according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension guidelines. Papers eligible for inclusion must be peer-reviewed publications in English involving smartphone applications used by adolescents or young adults aged 10–25, with a focus on depression, anxiety or suicidal ideation. Two independent reviewers will review and extract articles using a template developed by the authors. We will analyse the data using narrative synthesis and descriptive statistics. This study will identify gaps in the literature and provide a roadmap for equitable and inclusive mental health apps for youth.

Ethics and dissemination

Ethics approval is not required. Findings will be disseminated through academic, industry, community networks and scientific publications.

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Most cited references 24

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PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Adrian Aldcroft, Chantelle Garritty, Simon Lewin … (2018)

Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.

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Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review.

Robert Reiss (2013)

Socioeconomic inequalities in health are an important topic in social sciences and public health research. However, little is known about socioeconomic disparities and mental health problems in childhood and adolescence. This study systematically reviews publications on the relationships between various commonly used indicators of socioeconomic status (SES) and mental health outcomes for children and adolescents aged four to 18 years. Studies published in English or German between 1990 and 2011 were included if they reported at least one marker of socioeconomic status (an index or indicators, e.g., household income, poverty, parental education, parental occupation status, or family affluence) and identified mental health problems using validated instruments. In total, 55 published studies met the inclusion criteria, and 52 studies indicated an inverse relationship between socioeconomic status and mental health problems in children and adolescents. Socioeconomically disadvantaged children and adolescents were two to three times more likely to develop mental health problems. Low socioeconomic status that persisted over time was strongly related to higher rates of mental health problems. A decrease in socioeconomic status was associated with increasing mental health problems. The strength of the correlation varied with age and with different indicators of socioeconomic status, whereas heterogeneous findings were reported for gender and types of mental health problems. The included studies indicated that the theoretical approaches of social causation and classical selection are not mutually exclusive across generations and specific mental health problems; these processes create a cycle of deprivation and mental health problems. The review draws attention to the diversity of measures used to evaluate socioeconomic status, which might have influenced the comparability of international epidemiological studies. Furthermore, the review highlights the need for individual-level early childhood interventions as well as a reduction in socioeconomic inequalities at a societal level to improve mental health in childhood and adolescence. Copyright © 2013 Elsevier Ltd. All rights reserved.

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When and how do young people seek professional help for mental health problems?

Chris C. Wilson, Richard Deane, Debra J Rickwood (2007)

Despite the high prevalence of mental health problems and disorders that develop in adolescence and early adulthood, young people tend to not seek professional help. Young men and young people from Indigenous and ethnic minority groups tend to be those most reluctant to seek help. Young people are more inclined to seek help for mental health problems if they: have some knowledge about mental health issues and sources of help; feel emotionally competent to express their feelings; and have established and trusted relationships with potential help providers. Young people are less likely to seek help if they: are experiencing suicidal thoughts and depressive symptoms; hold negative attitudes toward seeking help or have had negative past experiences with sources of help; or hold beliefs that they should be able to sort out their own mental health problems on their own. Young people may seek help through talking to their family and friends, with family being more important for younger adolescents, and friends and partners becoming more influential later on. The professionals most likely to act as gatekeepers to mental health services for young people are school counsellors, general practitioners, and youth workers. Increasingly, Internet-based information and interventions are being used to engage young people in the help-seeking process.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2024

Publication date (Electronic): 7 May 2024

Volume: 14

Issue: 5

Electronic Location Identifier: e081673

Affiliations

[1 ] departmentPolicy, Technology and Management , Ringgold_2860Delft University of Technology , Delft, The Netherlands

[2 ] School of Social Welfare, University of California Berkeley , Berkeley, California, USA

[3 ] departmentBrown School of Social Work , Ringgold_7548Washington University in St Louis , St Louis, Missouri, USA

[4 ] departmentInstitute for Juvenile Research and Department of Psychiatry , University of Illinois at Chicago , Chicago, Illinois, USA

Author notes

[Correspondence to ] Dr Caroline A Figueroa; c.figueroa@ 123456tudelft.nl

Author information

Caroline A Figueroa http://orcid.org/0000-0003-0692-2244

Kathleen W Guan http://orcid.org/0000-0002-0044-0140

Article

Publisher ID: bmjopen-2023-081673

DOI: 10.1136/bmjopen-2023-081673

PMC ID: 11086474

PubMed ID: 38719322

SO-VID: 4e1b5990-cc7a-43b7-85dd-c92d17b2b5f1

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 03 November 2023

Date accepted : 26 March 2024

Funding

Funded by: High Tech for a Sustainable Future’ capacity building programme of the 4TU Federation in the Netherlands;

Award ID: N/A

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special-feature unlocked

ScienceOpen disciplines: Medicine

Keywords: adolescent,health equity,mental health,ehealth

Data availability:

ScienceOpen disciplines: Medicine

Keywords: adolescent, health equity, mental health, ehealth

Diversity, equity and inclusion considerations in mental health apps for young people: protocol for a scoping review

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Abstract

Introduction

Methods and analysis

Ethics and dissemination

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Novel Coronavirus Disease COVID-19

Most cited references 24

PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review.

When and how do young people seek professional help for mental health problems?

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Author notes

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