Dana B. Mukamel

Authors aim to examine the extent to which patterns of adoption of counseling services and digital mental health interventions (DMHIs) shifted in recent years (2019–2021), the impact of distress on adoption of mental health support, and reasons related to adolescents' low adoption of DMHIs when experiencing distress.

Data were from three cohorts of adolescents aged 12–17 years (n = 847 in 2019; n = 1,365 in 2020; n = 1,169 in 2021) recruited as part of the California Health Interview Survey (CHIS). Researchers examine the likelihood of using mental health support as a function of psychological distress, sociodemographic characteristics, and cohorts. They also analyzed adolescents' self-reported reasons for not trying DMHIs as a function of distress.

Findings: The proportion of adolescents reporting elevated psychological distress was higher than those adopting counseling services or DMHIs. A higher level of distress was associated with a greater likelihood of receiving counseling and using DMHIs to connect with a professional and for self-help. Among those experiencing high distress, adolescents' top reason for not adopting an online tool was a lack of perceived need.

Adolescents' main barriers to DMHI adoption included a lack of perceived need, which may be explained by a lack of mental health literacy. Thoughtful marketing and dissemination efforts are needed to increase mental health awareness and normalize adoption of counseling services and DMHIs.
 

The Innovation Technology Suite (branded as Help@Hand in 2019) was a five-year statewide demonstration funded by Prop 63 (now known as the Mental Health Services Act) between 2017–2024 and had a total budget of approximately $101 million. It brought a set (or “suite”) of mental health technologies into the public mental health system and intended to understand how mental health technologies fit within the public mental health system of care. In addition, Help@Hand led innovation efforts by integrating peers throughout the program.

The primary purpose of Help@Hand, a demonstration project that brought a set of mental health technologies into the public mental health system, was to increase access to mental health care and support, promote early detection of mental health symptoms, and predict the onset of mental illness. Each county/city who participated in the project sought to develop a complementary support system to bridge care, offer timely support, remove barriers, and to create new avenues of care for communities not connected to conventional county services and/or to build out support for those who are connected.

In Year 5, Los Angeles County, Marin County, Mono County, Monterey County, Orange County, Tehama County, and Tri-City concluded their involvement in Help@Hand. The City of Berkeley, Riverside County, San Francisco County, and Santa Barbara County will finish their participation in 2024. Throughout 2023, all counties/cities planned the end of their projects, examined how to sustain activities, and evaluated project achievements and challenges to inform future endeavors.

This study cites 2019–2022 California Health Interview Survey (CHIS) data.
 

​Patients have many alternatives to a hospital emergency room when they need medical care for an illness or injury that occurs at night or on the weekend: Urgent care centers, retail clinics, virtual physicians who diagnose over the internet, nurse advice lines ― and ― in some major cities ― physicians who make house calls. But what care settings are patients likely to choose?

To answer this question, authors surveyed over 5,000 employees at the University of California, Irvine campus,  a diverse population representing all socioeconomic strata. Based on an analysis of their responses, authors created a publicly available simulation model that allows users to understand what care settings are most likely to be chosen by different populations when faced with different clinical situations. The general findings:

• Patients are more likely to choose less costly care settings and settings with less wait time, but that cost is more important than wait time. 
• Both those choices depend on the severity of the injury or the disease. 
• Travel time does not affect choice.

• Dana B. Mukamel, PhD, MS
• Alpesh Amin
• Heather Ladd
• Dara H. Sorkin, PhD