A search in the iPhone app store for “mindfulness-based stress reduction” produces a seemingly endless stream of applications devoted to meditation. But do they work as well as having a live person with whom you can interact on the other side of the screen?
A study funded in 2020 by Patient Centered Outcomes Research Institute hopes to find out. The study aims to give providers guidance in using technology-based alternatives for mental health care in minority and other underserved communities during the COVID-19 pandemic and beyond.
African American and other minority communities have borne a disproportionate rate of infection and death during the pandemic, based on Centers for Disease Control and Prevention statistics. African Americans, Native Americans and Latinos have had a higher rate of infection and hospitalization than white, non-Hispanic individuals and African Americans have died at almost twice the rate of whites. Latinos and Native Americans have died at more than twice the rate of whites.
Higher infection and death rates in African American and other minority communities, combined with shelter-in-place orders, have intensified mental health concerns by contributing to increased loneliness, stress, anxiety, depression and fear. The pressures associated with the pandemic are especially worrying with regard to men, who are almost four times more likely to commit suicide than women, according to Men’s Health Network.
“Unlike most physical health disorders, mental health disorders are frequently stigmatized,” according to Jean Bonhomme, M.D., founder of National Black Men’s Health Network. “People may be labeled crazy, leading to persons being ostracized, ashamed, and reluctant to seek help. For men and boys, these problems can be amplified by cultural expectations that men be stoic.”
Bonhomme served as program principal for a 2019 conference called “Behavorial Aspects of Anxiety and Depression in the American Male.” Men’s Health Network, a Washington, D.C.-based non-profit that advocates for men and boys on a variety of issues worked with the Patient-Centered Outcomes Research Institute (PCORI) to stage the conference.
Even though the rate of behavioral health disorders among African Americans and Latinos doesn’t differ significantly from the general population, they often have lower access to mental health and substance abuse treatment services at the best of times, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Telehealth, using mindfulness-based stress reduction, offers a way to address the additional challenge of providing mental health care posed by the pandemic. Mindfulness-based stress reduction is an eight-week program offering intensive mindfulness training to assist people with stress, anxiety, depression and pain. It was developed in the late 1970s by Jon Kabat-Zinn, professor emeritus of medicine at the University of Massachusetts.
Research at Harvard, UCLA, Stanford, the University of Wisconsin at Madison and other high-ranking institutions provides insight into how MBSR works and can actually can change our brains for the better, according to an article in Psychology Today by Will Baum.
For his doctoral dissertation, Thomas E. Owens, a student at the University of Pennsylvania, studied 14 African American men, ages 27 to 61 who practiced mindfulness meditation (eight had completed MBSR training, others were self-taught) to determine if the practice helped them buffer the emotional, mental and social impact of psychosocial stressors.
Owens’ observations and conclusions were encouraging with regard to the benefits of MBSR.
Participants’ comments and stories indicated that the mindfulness meditation practice enhanced their intimate relationships and helped them maintain a healthy consistent state of wellbeing, even among vast societal challenges. Participants also suggested that if the concepts of mindfulness meditation had been introduced to them at an earlier age their lives might have been different in that they might have been better listeners, more confident and more patient with themselves and others.
The PCORI funded study will compare teleconferencing with a mobile app. Both have already been used in clinical settings. A team from The Research Foundation of the State University of New York will recruit 178 participants, 89 for each group. The primary goal of treatment will be to reduce worry, with a secondary goal of reducing levels of anxiety, stress, depression, loneliness, isolation and improving sleep, mindfulness and quality of life.
When the study is complete in 2023, it will provide insight into how each of these telehealth methods of delivering mindfulness-based stress reduction works. In a positive development on this front, in 2020 the Centers for Medicare and Medicaid Services broadened its willingness to pay for telehealth services. Health care providers throughout the country should be able to quickly take advantage of the findings to deliver better mental health care to underserved communities that have been further traumatized by the pandemic.