Black Adolescent Experiences with COVID-19 and Mental Health Services Utilization.
Ontology highlight
ABSTRACT: Background
COVID-19 is disproportionately impacting communities of color. Black adolescents are among the most vulnerable to COVID-19, have high mental health service needs, and have low mental health services utilization. During this time of great physical threat due to COVID-19, it is equally important to understand and support the mental health of Black adolescents.Method
This study collected open-ended survey item responses from adolescents (12-17 years old) that identified as Black, living in a city in the Southeastern United States (n = 33). Grounded theory was used to analyze the data, revealing details of the lived experience of these Black adolescents during the COVID-19 pandemic.Results
Black adolescents reported that COVID-19 has been both positive and negative for them. Family is of utmost importance to them, as are their peers, whom they do not get to interact with due to changes in the operation of schools. Despite experiencing stress, adaptive responses to COVID-19 are reported. Black adolescents continue to cite issues with mental health services and providers. Financial issues were a common theme for these youth, blocking access to services and causing issues in the home environment.Conclusions
Mental health service providers must address the service access and quality issues repeatedly reported by Black adolescents. Direct action must be taken to facilitate an increase in Black adolescents mental health services utilization and satisfaction. Changes are needed at the individual and macro levels to alter the experience of one of our most vulnerable groups.
SUBMITTER: Banks A
PROVIDER: S-EPMC8080856 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveThe objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and Biracial adolescent and young adult women during the COVID-19 pandemic.MethodsBlack and Biracial participants ages 16-23 were recruited for virtual individual semi-structured interviews. Participants (n = 25) were asked about pre- and post-natal experiences with the healthcare system, effects of the pandemic, and participants' experiences of or desires for ideal care within the healthcare system. Interviews were transcribed verbatim and coded for qualitative analysis using nVivo. Discussions around postpartum mental health evolved organically when asked about how participants were coping postpartum.ResultsNearly half the interviewees organically reported mental health symptoms consistent with postpartum depression (PPD) during questions regarding their postpartum experience. Of the 11 interviewees who reported mental health symptoms consistent with PPD, 2 were afraid to disclose their symptoms to a healthcare provider due to fear of child protective services involvement and their belief they would be treated unfairly because of their race.ConclusionClinicians who care for Black and Biracial adolescent and young adult mothers must be particularly attuned to structural barriers for appropriate screening and treatment of postpartum depression. Expanding investigations of intersectional influences on young mothers' perinatal health and PPD are needed.
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Project description:BackgroundThe COVID-19 pandemic and associated responses have induced a host of crises worldwide, including an economic recession and a global mental health crisis. The specific effects of recession on youth mental health are understudied. We aimed to examine the mechanisms by which pandemic-related financial strain may affect mental health in a diverse sample of American adolescents.MethodsWe analyzed data from the Adolescent Brain Cognitive Development Study (ABCD Study®), a large, longitudinal study of diverse US adolescents which collected data before and during the pandemic (N = 9,720, mean age 12.9 years, 18.2% Black). Linear mixed-effects models tested associations of financial strain (parent-reported household wage loss and youth-reported financial stress) with depressive symptomatology over time, covarying for multiple confounders including pre-pandemic socioeconomic status and psychopathology, and pandemic-related environmental factors. Longitudinal mediation analyses examined potential mechanisms leading from wage loss to youth mental health.FindingsFinancial strain was highly prevalent, especially among low-income participants, with >70% of the total sample reporting lost wages. Both wage loss and subjective financial stress were associated with depressive symptomatology over time (Estimate = 0.04, P = 0.014; Estimate = 0.17, P < 0.001; respectively). The association between financial stress and depressive symptomatology was robust to the addition of multiple environmental confounders (Estimate = 0.16, P < 0.001). Both family-level (family conflict) and individual-level (financial stress) factors mediated the relationship between wage loss and depressive symptomatology.InterpretationThe financial effects of COVID-19 (and worldwide responses to it) have taken a significant toll on youth mental health. In families that lost wages, youth-reported financial stress and familial factors mediated the relationship between wage loss and mental health over time. Findings highlight financial stress as a key driver of youth mental health burden and identify familial factors as critical targets for intervention to mitigate mental health risks in periods of economic crises.FundingThis study was supported by the National Institute of Mental Health [grant numbers K23MH120437 (RB), R01MH117014 (TMM)]; the Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania.
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Project description:Lombardy is the Region in Italy the most heavily affected by coronavirus disease (COVID-19) contagion. The Regional Health Authority mandates that mental health services should be guaranteed, identifying mental health as a priority for their citizens. Recommendations for occupational and health safety have been provided to patients and hospital staff, including support for telemedicine activities and remote psychosocial interventions. Services of the Mental Health Departments of Milano "Niguarda" and Brescia "Spedali Civili" Hospitals are providing continued care at a community, residential and hospital level, and to positive COVID-19 psychiatric patients in need of hospitalization.
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Project description: Not available
| S-BSST1055 | biostudies-other
Project description:ImportanceThe association of the COVID-19 pandemic with women's preventive health care use is unknown.ObjectiveTo describe utilization of women's preventive health services.Design setting and participantsCross-sectional study of women aged 18 to 74 years enrolled in a commercial health maintenance organization in Michigan.ExposuresCOVID-19 pandemic (2019-2020).Main outcomes and measuresAdjusted odds ratios (AORs) of receiving breast cancer screening, cervical cancer screening, sexually transmitted infection (STI) screening, long-acting reversible contraception (LARC) insertions, and pharmacy-obtained contraception, adjusted for month, age, county, zip code characteristics (per-capita income, non-White percentage of population, non-English-proficient percentage of population), and plan designation (primary plan holder vs dependent).ResultsThe study population included 685 373 women aged 18 to 74 years, enrolled for 13 000 715 person-months, of whom 10 061 275 person-months (77.4%) were among women aged 25 to 64 years and 8 020 215 (61.7%) were the primary plan holder, with mean zip code per capita income of $33 708, 20.2% mean zip code non-White population, and 3.4% mean zip code non-English-speaking population. For services requiring an in-person visit (breast cancer screening, cervical cancer screening, STI testing, and LARC insertions), utilization declined by 60% to 90% during the spring of 2020, with a nadir in April 2020, after which utilization for all services recovered to close to 2019 levels by July 2020. Claims for pharmacy-obtained hormonal contraceptives in 2020 were consistently 15% to 30% lower than 2019. The AORs of a woman receiving a given preventive service in 2020 compared with 2019 were significantly lower for breast cancer screening (AOR, 0.80; 95% CI, 0.79-0.80), cervical cancer screening (AOR, 0.80; 95% CI, 0.80-0.81), STI screening (AOR, 0.83; 95% CI, 0.82-0.84), LARC insertion (AOR, 0.87; 95% CI, 0.84-0.90), and pharmacy-obtained contraception (AOR, 0.73; 95% CI, 0.72-0.74) (all P < .001).Conclusions and relevanceIn this cross-sectional study of women enrolled in a large US commercial health maintenance organization plan, the COVID-19 pandemic was associated with large but transient declines in rates of breast cancer screening, cervical cancer screening, STI screening, and LARC insertions, and moderate persistent declines in pharmacy-obtained hormonal contraceptives. The overall odds of a woman receiving a given preventive service in 2020 was 20% to 30% lower than 2019. Further research into disparities in access to care and the health outcomes of decreased use of these key health services is warranted.
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