Survey 2 participant demographics.

The COVID-19 pandemic had an unprecedented impact on global mental health and well-being, including across the Asia-Pacific. Efforts to mitigate virus spread led to far-reaching disruption in the delivery of health and social services. In response, there was a rapid shift to the use of digital mental health (DMH) approaches. Though these technologies helped to improve access to care for many, there was also substantial risk of access barriers leading to increased inequities in access to mental health care, particularly among at-risk and equity-deserving populations. The objective of this study was to conduct a needs assessment and identify priorities related to equitable DMH access among at-risk and equity-deserving populations in the Asia Pacific region during the first year of the COVID-19 pandemic. The study consisted of a modified Delphi consensus methodology including two rounds of online surveys and online consultations with stakeholders from across the region. Study participants included policy makers, clinicians and service providers, and people with lived experience of mental health conditions. Results demonstrate that vulnerabilities to negative mental health impacts and access barriers were compounded during the pandemic. Access barriers included a lack of linguistically and culturally appropriate DMH options, low mental health literacy and poor access to technological infrastructure and devices, low levels of awareness and trust of DMH options, and lack of policies and guidelines to support effective and equitable delivery of DMH. Recommendations to improve equitable access include ensuring that diverse people with lived experience are engaged in research, co-design and policy development, the development and implementation of evidence-based and equity-informed guidelines and frameworks, clear communication about DMH evidence and availability, and the integration of DMH into broader health systems. Study results can inform the development and implementation of equitable DMH as its use becomes more widespread across health systems.

新冠疫情（COVID-19 pandemic）对全球乃至亚太地区的心理健康与福祉造成了前所未有的冲击。为遏制病毒传播所采取的各项防控措施，对医疗与社会服务的正常供给造成了深远干扰。为此，相关领域快速转向数字化心理健康（digital mental health, DMH）服务模式。尽管此类技术有效改善了多数人群的心理健康诊疗可及性，但同时也存在显著的可及性障碍风险，可能加剧心理健康诊疗服务的公平性失衡问题，尤其针对高风险群体与应受公平对待的群体而言。本研究旨在针对新冠疫情首年期间，亚太地区高风险群体及应受公平对待群体的数字化心理健康服务公平可及性开展需求评估，并明确相关工作优先级。本研究采用改良德尔菲共识法（modified Delphi consensus methodology），包含两轮在线调研以及与亚太地区各利益相关方开展的在线咨询活动。研究参与者涵盖政策制定者、临床医护人员、服务提供者，以及有心理健康问题亲身经历的群体。研究结果显示，疫情期间人群遭受心理健康负面影响的脆弱性与诊疗可及性障碍均进一步加剧。具体而言，可及性障碍包括：缺乏符合语言与文化适配性的数字化心理健康服务选项、民众心理健康素养水平偏低、技术基础设施与设备可及性不足、对数字化心理健康服务的认知度与信任度较低，以及缺乏支撑数字化心理健康服务有效且公平供给的政策与指南。为提升数字化心理健康服务的公平可及性，本研究提出以下建议：确保多元化的心理健康亲历者群体参与研究、共同设计与政策制定环节；制定并落实基于循证证据且兼顾公平性的指南与框架；清晰传播数字化心理健康服务的相关证据与可及性信息；以及将数字化心理健康服务纳入整体医疗体系。随着数字化心理健康服务在全球医疗体系中的应用愈发广泛，本研究结果可为公平化数字化心理健康服务的开发与落地提供重要参考依据。