Use of a Smartphone Application for Latinos with Mental Health and Substance Abuse Disorders

Latinos are one of the fastest growing ethnic groups with a disproportionate rate of disease, mental illness, and poverty. Co-occurring alcohol and other drug disorders (AOD) and Mental Health Disorders (MHD) are persistent and associated with more severe substance abuse, greater psychosocial problems, being homeless, poorer treatment outcomes, and more frequent relapses. Sustained participation in ongoing treatment for AOD and MHD is associated with improved outcomes; however, continuing of care is rare, despite these conditions’ chronicity. Latinos with co-occurring disorders face unique challenges in their lifelong process of recovery; managing chronic health conditions, financial and legal issues, and problems with housing and employment. Latinos are less likely to have health insurance and report high cost as a barrier to seeing a doctor. Few culturally and linguistically competent services exist, compounded by a dearth of Latino mental health professionals. Smartphone-based technology may reduce the risk of relapse, increase medication adherence, improve mental well-being, and provide culturally sensitive support for Latinos in recovery. Smartphone use among Latinos exceeds that of Whites; additionally, Latinos report being open to adopting mobile health interventions. The purpose of this paper is to: (1) describe a smartphone application for continuing care that has been adapted for Spanish-speaking Latinos who successfully completed residential treatment for AOD and MHD and (2) present initial findings regarding patterns of usage of this application.

Spanish-speaking Latino/a adult clients with AOD and MHD who were successfully completing a residential treatment program in the Northeast were randomly assigned to standard aftercare or standard aftercare plus a smartphone intervention, the evidenced-based relapse prevention application A-CHESS (Alcohol-Comprehensive Health Enhancement Support System) adapted for Spanish-speaking Latinos (CASA-CHESS) with AOD and MHD.  This app aims to reduce risk of relapse, increase medication adherence, and improve mental well-being and social connectedness. Usage patterns were examined over the first 6 months using log-in timestamps, app feature type, time spent on app feature type, pages visited, and message activity.

Participants (n=~50) were approximately 38 years old, 90% identified as Hispanic/Latino (78% were Puerto Rican).  Approximately 70% were male, 60% had less than a high school education, 50% had never been married, 30% have a job, and 80% had been in jail at least once. Most had been in addiction treatment previously, and 40% had been prescribed medications for emotional problems during the past month. Participants used CASA-CHESS with regularity, the greatest rate of participation occurred in the morning. Usage was sustained over time with the most commonly utilized features including messaging, discussion boards, and surveys.

Findings illustrate that Spanish-speaking Latinos with AOD and MHD will use a Smartphone app to assist with their recovery, continuing their access to resources, case management, peer-based support and quality information after leaving residential treatment.  Such interventions may not only extend access to care but result in longer healthier lives. It is critical that social workers participate in the development and research of tech-based evidence-based practices for diverse populations with mental health and substance abuse problems.