Harnessing Network Science to Personalize Scalable Interventions for Adolescent Depression

项目总结/文摘

Project Summary/Abstract Up to 80% of U.S. adolescents with depression will never access treatment. An often-overlooked contributor to this discrepancy is teens’ inability to access care independently. Historically, teens’ access to mental health treatment and research has required parental consent, yet many teens cite parents as a barrier to accessing mental health support. Positioning parents as gatekeepers to treatment may prevent all but the most privileged teens from accessing depression-related support. To date, some (but not all) U.S. states have enacted laws allowing youth aged ≥12 to consent, without a parent, to mental health care, and emerging research supports the safety and utility of these policies. For instance, across multiple NIH-funded trials, my research team has secured waivers of parent consent from our University IRB, allowing us to run trials of online single-session interventions (SSIs) in which teens with depression can self-refer into our studies (DP5OD028123-S1). Our results show that teens can safely engage in online SSIs, and that SSIs can reduce depression severity up to 3 months later. Waiving parental consent requirements also seemed to boost our sample’s diversity, allowing us to recruit population-congruent proportions of Black, Hispanic, Asian, and Native American adolescents in a recent nationwide trial (N=2,452). Most youth therapy trials include samples that are >90% white. Thus, national policies allowing teens to self-refer into certain kinds of mental health support may improve access to care for diverse adolescents. Despite this possibility, there are no formal policies for researchers, clinicians, or families for facilitating adolescents’ self-referral into mental health research or treatment. Characterizing teens’ perspectives is a necessary step toward creating youth-centered policies to guide circumstances under which teens should (and should not) be able to self-refer into mental health interventions and research. Therefore, the goal of this supplement project is to characterize adolescents’ views on teens’ self-referral into mental health research and treatment, integrating survey-based and interview data from adolescents with depression (N=30 from the Parent Grant sample, whose parents were involved in study consent, and N=15 drawn a social media-recruited sample, whose parents will not be involved in study consent). Specific aims are (1) to characterize what adolescents view as the benefits and risks of teens accessing mental health support without parent knowledge/consent; (2) to gauge whether adolescents’ views on this topic differ for supports that are offered in-person versus online; supports that do versus do not involve a therapist (i.e., self-help); and whether teens perceive their identities and symptoms as shaping their views on parental knowledge/consent in teen mental health research and treatment; and (3) to compare responses to (1) and (2) across teens whose parents were and were not involved in study consent procedures. This study will yield necessary insights toward policies on adolescents’ independent participation in mental health treatment and research, with sweeping implications for teens’ access to mental health care.