JMIR Publications

ABSTRACT

Background:

Urban Indigenous populations face disproportionate mental health challenges, including high rates of PTSD, depression, and substance use disorders, yet they have limited access to health services, especially culturally relevant care. The mechanism for providing care to Indigenous people in the US, the Indian Health Service (IHS), is significantly underfunded. and only accessible to certain Indigenous people. With over 70% of Indigenous individuals in the U.S. living in urban settings, there is a growing need for innovative healthcare solutions.

Objective:

Aim 1: Assess changes in client attitudes related to telemental health treatment value and trust in ShockTalk technology and Aim 2: Assess the accessibility, experience, and value of ShockTalk for practitioners and clients interested in providing or receiving culturally responsive mental health treatment

Methods:

The conceptual framework is based on the Behavioral Model of Health Care Utilization. ShockTalk uses AI to connect clients with Indigenous or culturally aligned therapists and facilitates access to care via Facebook Messenger. Using a pre/post waitlist design, 5 participant clients will be admitted to the study at first and 5 additional at 3months. Data collection includes pre/post surveys on client attitudes towards mental health treatment and trust in the ShockTalk platform at baseline and 3 month follow up, followed by in-depth qualitative interviews at 3 months. A cost-effectiveness analysis will assess the impact of varying levels of treatment engagement on client outcomes.

Results:

Funded April 2022. Data collection occurred between May 2022 and October 2024. Four participants were enrolled. Data analysis and results are expected to be published in early 2025.

Conclusions:

This pilot study will offer insights into optimizing technology-based, culturally relevant mental health care. By examining varying levels of engagement and associated costs, the research seeks to identify the most effective and cost-efficient strategies for improving mental health outcomes in urban Indigenous populations. ShockTalk has the potential to shape future healthcare innovations in this field. Findings are expected to contribute significantly to Indigenous mental health care by offering insights into sustainable, accessible, and culturally appropriate telehealth interventions, guiding future policy and practice.