MENTAL-HEALTH INTERVENTIONS FOR BLACK AND ASIAN ADULTS IN U.S. PUBLIC AND COMMUNITY SETTINGS: A QUANTITATIVE SYSTEMATIC REVIEW

Abstract

Mental-health disparities continue to be an important public-health issue in the United States, and racial and ethnic dinsparities have been observed in access to mental-health services, treatment uptake, treatment engagement and recovery. Black and Asian adults have mental-health needs, but receive lower rates of treatment than White adults. The purpose of this systematic review was to determine the efficacy of public and community mental-health interventions for Black and Asian adults in the United States, focusing on clinical outcomes and equity measures like treatment initiation, retention, adherence, completion, and continuity of care. The quantitative systematic review was conducted using data extracted from scientific literature and was based on the PRISMA 2020 guidelines. MEDLINE, CINAHL and Web of Science databases were searched from 2015 to 2025 with the addition of grey literature searching. Eligibility criteria were set up using the PICO structure and methodological quality were evaluated by Critical Appraisal Skills Programme (CASP) checklist for randomised controlled trial. Seven randomised trials met the inclusion criteria. Interventions ranged from culturally adapted cognitive behavioural therapy (CBT), mindfulness-based cognitive therapy (MBCT), trauma-informed collaborative care, anxiety-management with resource navigation, to digitally delivered CBT. Among Chinese American adults, symptom improvement was quicker and attrition was lower for those receiving culturally and linguistically adapted CBT. Collaborative and navigation-based models had shown continuity, and digitally delivered interventions had shown significant reach, but also had issues with treatment initiation and completion. It was possible and acceptable, but the evidence of comparative clinical effectiveness was more inconsistent, regarding mindfulness-based interventions. In sum, the results suggest that intervention content is not enough to decrease the gap in mental health inequalities. Language, cultural relevance, practical barriers, navigation and sustained engagement are key issues to consider in equitable public health intervention through delivery mechanisms.