Digital mental health interventions (DMHIs) provide tools to seek mental health resources, providers, and facilitate and/or complement in-person treatment. Limited research has examined what factors are associated with DMHI uptake. Authors used California Health Interview Survey (CHIS) data to examine DMHI use among California adults (2019–2022), estimating three multi-variable logistic regression models to assess if DMHI use to seek mental health support (Model 1), connect with mental health professionals (Model 2), and connect with others with similar concerns (Model 3) varied by psychological distress or sociodemographic variables. Wald Chi-square statistics tests were used to examine reasons for not using DMHIs by the same variables.

Findings: DMHI use to seek mental health support and connect with professionals increased between 2019–2022. High psychological distress individuals used DMHIs for all three outcomes significantly more than low/no distress individuals. The top reason for not using online tools regardless of distress was in-person treatment. The second reasons were low perceived treatment utility (high/medium distress individuals), and low perceived need (low/no distress individuals). Overall, younger, female, more educated, insured, unmarried, and non-Hispanic White participants were more likely to use DMHIs than older, male, less educated, uninsured, married, and Asian counterparts. Adult DMHI use to seek mental health support and professional treatment increased between pre-pandemic and pandemic years. Many respondents who did not use DMHIs sought in-person support.

Future research can examine how to increase perceived DMHI efficacy among people with high/medium distress.
 

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.
 

Authors study the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia census to understand the association of staffing hours with dementia care quality. They estimated separate linear models predicting six long-term facility-level outcomes. Independent variables included staffing hours per resident-day (HPRD) interacted with the facility percentage of dementia residents, controlling for other resident and facility characteristics.

Findings: Authors found that registered nurses' and certified nurse assistants' HPRDs were likely to exhibit positive returns in terms of outcomes throughout most of the range of HPRD for both high and low-census dementia facilities, although, high- and low-dementia facilities differed in most outcome rates at all staffing levels. Average predicted antipsychotics and activities of daily living as functions of HPRD were worse in higher dementia facilities, independent movement, and hospitalizations did not differ significantly, and Emergency Rooms and pressure sores were worse in lower dementia facilities.

These findings suggest that increasing staffing will improve outcomes by similar increments in both low- and high-dementia facilities for all outcomes. However, at any given level of staffing, absolute differences in outcomes between low- and high-dementia facilities remain, suggesting that additional staffing alone will not suffice to close these gaps. Further studies are required to identify opportunities for improvement in performance for both low- and high-dementia census facilities.