Stiles-Shields Colleen, Ramos Giovanni, Ortega Adrian, Psihogios Alexandra M
Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois, Chicago, Chicago, IL, USA.
Center for Health Equity using Machine Learning & Artificial Intelligence, College of Medicine, University of Illinois, Chicago, Chicago, IL, USA.
Npj Ment Health Res. 2023;2. doi: 10.1038/s44184-023-00030-1. Epub 2023 Jun 27.
Youth in the United States are facing an unprecedented mental health crisis. Yet, brick-and-mortar mental healthcare, such as face-to-face therapy, is overwhelmingly inaccessible to youth despite research advances in youth mental health. Digital Mental Health tools (DMH), the use of technologies to deliver mental health assessments and interventions, may help to increase mental healthcare accessibility. However, for a variety of reasons, evidence-based DMH have not been successful in reaching youth in real-world settings, particularly those who are most encumbered with access barriers to mental healthcare. This Comment therefore focuses on increasing DMH reach and uptake by young people, particularly among minoritized youth, by engaging in community-based youth partnerships. This idea recognizes and grows from decades' worth of community-based participatory research and youth partnerships successfully conducted by other disciplines (e.g., social work, public health, urban planning, education). Increasing uptake and engagement is an issue that is unlikely to be solved by adult-driven theory and design. As such, we emphasize the necessity of reframing youth input into DMH design and deployment from one-time participants to integral community-based partners. Indeed, recognizing and valuing their expertise to equitably address DMH implementation challenges, youth should help to pose the very questions that they will help to answer throughout the design and implementation planning for DMH moving forward.
美国的青少年正面临着一场前所未有的心理健康危机。然而，尽管青少年心理健康研究取得了进展，但诸如面对面治疗等实体心理健康护理服务，青少年却极难获得。数字心理健康工具（DMH），即利用技术提供心理健康评估和干预措施，可能有助于提高心理健康护理服务的可及性。然而，由于种种原因，基于证据的数字心理健康工具在现实环境中未能成功惠及青少年，尤其是那些在获得心理健康护理方面障碍最大的青少年。因此，本评论着重探讨通过建立基于社区的青少年伙伴关系，来提高数字心理健康工具对年轻人，尤其是少数族裔青少年的覆盖范围和使用率。这一理念源于其他学科（如社会工作、公共卫生、城市规划、教育）数十年来成功开展的基于社区的参与性研究和青少年伙伴关系，并在此基础上发展而来。提高使用率和参与度这一问题，不太可能通过成人主导的理论和设计来解决。因此，我们强调有必要将青少年在数字心理健康工具设计和部署中的作用，从一次性参与者重新定位为基于社区的重要合作伙伴。事实上，认识到并重视他们在公平应对数字心理健康工具实施挑战方面的专业知识，青少年应该在数字心理健康工具未来的设计和实施规划中，提出他们自己将帮助解答的问题。
