LITERATURE REVIEW

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 Table of Contents

Introduction 3

Section 1: Mental Health Disparities in Racial Minority Groups 3

Section 2: Mobile phone applications, websites, and other forms of technology in the field of
mental health 4

Section 3: Inequities in minority utilisation of mental health applications 5

Future Research 6

References 8

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Introduction
Inclusion, inequality,and diversity—particularly racial inequality—were emphasised in 2020.
The COVID-19 pandemic drew attention to the inequality in clinical outcomes for people
with different racial backgrounds, notably the greater mortality rates among black and certain
Asian patients [22]. The Black Lives Matter movement has also prompted more constructive
conversations about the broader inequality and marginalisation that people face merely
because of their colour. Online platforms (such as mobile apps and websites) have been
utilized to provide health assistance and knowledge resources more often during COVID-19,
and this pattern is expected to persist beyond the pandemic.

Section 1: Mental Health Disparities in Racial Minority Groups

The "mental health paradox," as it was named by academics, is a by-product of the
reasonably secure but paradoxical disparities regarding race and ethnicity in mental wellbeing
conditions over the past few decades. Black, Asian and Hispanic people often suffer from low
rate of mental health issues than non-Hispanic adults (White), as per studies, the
preponderance of which were undertaken before the COVID-19 pandemic [15]. In light of the
stress-inducing difficulties that racism has caused for these communities, researchers have
pointed out the contradictory aspect of these findings [20]. As an instance, whereas White
individuals report a lower rate of psychological problems, Hispanic and Black adults reported
significantly more suffering from social stress and worsening good health. [4].

With the enormous impact during COVID-19 pandemic on mental fitness among the
inhabitants, as well as the racial inequalities in disease and mortality created by the pandemic
[11], issues about mental health and inequalities in treatment for mental illnesses are
especially significant now. The pandemic itself created numerous stresses and concentrated
people's assets, restraining the access to communal aid resulting in economic instability [21].
In accordance with the stress process model, it has been anticipated that increased
concentrations of stressors would result in overall worse mental health, as has recently been
well documented [7]. Early in the COVID-19 outbreak, it became apparent that minority
communities were much more seriously impacted by the pandemic's damaging consequences
[3]. This was significant in surplus mortality rates, where early data showing that calculated
excess all-cause mortality during initial outbreak for white people was 1.5 per ten thousand,
for black people it was 6.8, 4.3 for Hispanic individuals and 2.7 for Asian persons [17].

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Research showed that unemployment, income loss, food scarcity and school shutdown was
prevalent among Hispanics and Blacks in general, than the White population, indicating that
these increased pressures and decreased resources were prevalent in other sectors as well
[16].

In 2019, the chance that a White respondent will suffer anxiety or depression was 0.11; for
Black respondents, the chance was 0.10, while the likelihood for Hispanic and Asian
participants was lower at 0.09 and 0.05, respectively. All ethnic and racial groups suffered
from considerably more depression and anxiety through the initial outbreak period in 2020
from April–May than in 2019, with Black, Asian, and Hispanic respondents exhibiting the
sharpest positive differences compared to White respondents. For respondents who classified
as White, 280 % were more inclined to identify as Black, 344% more probable to identify as
Hispanic also 560 % with higher probability to identify as Asian when comparing April-May
2019 to April-May 2020 [21].

Pairwise comparisons indicated that this caused a decrease in the disparity of psychological
wellbeing for Asians than Whites (from 0.07 in 2019 to 0.02 in April–May 2020), making
this disparity no longer statistically significant. A intersect in probability arrised for Hispanic
and Black participants throughout this time in comparison to Whites. Particularly, compared
to white respondents, black and Hispanic survey participants showed an increasing likelihood
of depression or anxiety by April–May 2020. Until the conclusion of the research period in
2021 from February–April, Hispanic participants still had worse mental health than white
respondents, although black and Asian participants' mental health fluctuated more over time
than white respondents' did [21].

Section 2: Mobile phone applications, websites, and other forms

of technology in the field of mental health
Anxiety as well as depression is believed to be accountable for 12 billion annual workday
absenteeism causing nearly deficit in world economy US$1 trillion [19]. Recent studies have
begun looking at how technologies can be employed to scale treatment and education to
patients as well as practitioners internationally as mental health professionals and healthcare
professionals seek to enhance the availability of medical care to tackle this problem [10].A
market study implied that in 2021 alone, mental wellbeing apps could earn up to $500 million
with an anticipated growth rate per year close to 20%, highlighting the rising trend of mobile-

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based mental healthcare applications. There are over 10,000 mental-health and well-being
mobile applications in both the Apple and Google Play stores [1].

These applications may be helpful in relieving the symptoms associated with anxiety,
depression, and other psychiatric conditions, as per research conducted by academics in both
psychology and human-computer interaction (HCI) [2, 6]. Based on a review by Fairburn and
colleagues, using digital technology may assist support and intervention approaches and
reach neglected groups with psychological treatments [5].

Results meta-analysis of 96 RCTs including a comprehensive study showed how DMH

instruments might represent a useful means of dealing with anxiety and depression in low-
resource settings when conventional therapy is only partially viable or available despite the
requirement for care and the urgency of the condition. Given the projected expansion of
demand, development, and utilization of DMH tools, this study presents an abundance of
evidence-based information into future prospects of DMH use for anxiety and depression in
LMICs [14].

Section 3: Inequities in minority utilisation of mental health

applications
Researchers from the University of Massachusetts Medical School, the Dana-Farber Cancer
Institute, and Florida Atlantic University teamed up on a research project to find out how
many elderly African Americans, Hispanic Americans, Afro-Caribbean persons and Euro-
Americans owned computer systems, had internet connectivity, and used digital healthcare
information. They used a number of focus groups to examine the causes of any disparities
among the 562 study participants' characteristics related to having electrical gadgets, having
internet access, and having the ability to access electronic health records. The study's
findings, which were released in the Journal of Racial and Ethnic Health Disparities, showed
the existence of a considerable digital health gap among older people [21]. In the community
sample including the focus groups this disparity was clear. People from ethnic communities
(Black Americans, Afro-Caribbeans, or Hispanic Americans) were very less enthusiastic
about digital healthcare information compared to younger and poorly educated participants or
Euro-Americans participants and participants with greater income. The most enthusiastic
Americans were Europeans, Black Americans, and Afro-Caribbeans when it came to finding
internet health-related information, while Hispanic Americans exhibited at best a moderate

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level of enthusiasm [13]. The participants' expressed preferences for searching independently
or for information about patients' doctors, including their involvement in decision-making,
differed significantly among groups, as did their economic capacity to spend on a gadget that
enables Internet connection. Although they recognised additional informational sources,
Afro-American and Afro-Caribbean members indicated displeasure with the difficulty in
accessing digital healthcare information. Hispanic people doubted the accuracy of health
information and prescription inserts, with some claiming that having an optimistic
perspective and having trust in God were equally critical aspects of healing from illness.
Participants from both North America and Europe reviewed multiple websites with digital
health records and sought providers' aid in adapting the data to their own situations [18].

People with mental health disorders may experience societal stigma, exorbitant costs, and
dispersed or unavailable resources in the United States [9]. Getting excellent, culturally
sensitive treatment is particularly difficult for people of colour. The term "mental health
disparity" refers to variations in health, health care services, and health-related issues. In
accordance with various research, racial and ethnic minorities continue to encounter large
disparities even after accounting for variables including income, status of insurance, age, and
symptom expression [8]. The absence of readily available high-quality mental health care, the
cultural stigma against pursuing such care, marginalisation, and a general lack of
understanding about mental health are just a few of the many obstacles that frequently result
in poor mental health outcomes for minorities who identify as racial/ethnic, gendered, or
sexual.

Cultural factors may be important in the development of mental disease. Many times,
different people are disproportionately burdened by the socio-demographic factors of mental
health, like poverty, racism, and exposure to violence. Several of these groups face cultural
obstacles while seeking therapy, such as language barriers, access issues, and mistrust of
mental healthcare.Healthcare organisations and professionals are better able to interact with
patients to develop understanding and minimise mistrust when they are aware of cultural
differences (using professional mental health interpreters when appropriate). This mutual
understanding is the first step towards a proper mental disease diagnosis and treatment plan.
The first connection should be given special consideration [12].

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Future Research
Every year, mental illness affects millions of individuals. Every day around the nation,
countless individuals just like individuals perform, develop, compete, laugh, adore, and
inspire. Adults in the US had mental illness in 2020 at a rate of 21%. (52.9 million people).
5% of adults meet this profile. 5.6% of adult Americans in America had a serious mental
illness in 2020 (14.2 million people). This applies to one in twenty adults. In 2016, 16.5% of
American children between the ages of 6 and 17 experienced a mental health issue (7 million
people). 6.7% of American individuals in 2020 had both a mental health illness and a drug
use issue (17 million people) [23].

Adults in the United States: Yearly prevalence of mental illness, by demographic group [23]:

● Non-Hispanic white: 22.6%

● Non-Hispanic Asian: 13.9%
● Non-Hispanic American Indian or Alaska Native: 18.7%
● Non-Hispanic black or African-American: 17.3%
● Non-Hispanic Native Hawaiian or Other Pacific Islander: 16.6%
● Non-Hispanic mixed/multiracial: 35.8%
● Hispanic or Latino: 18.4%

Progress has been marginal despite promises made by important national institutions over the
last ten years to tackle and erase inequities in mental health. Eliminating the disparity in
mental health calls for an ongoing commitment to improving treatment that is culturally
appropriate, in addition to advancing research and initiatives to eliminate stigma around
mental illness in minority communities.

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