CHAPTER 2

REVIEW OF RELATED LITERATURE AND STUDIES

The role of technology in mental health condition of the Senior High School

students amidst pandemic

PRACTICAL RESEARCH 2

Sir Leo B. Guarin

April 2021

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 This chapter provides up-to-date books vital for further understanding of the

whole title. The studies and literatures are by foreign and local researchers and were

carefully reviewed and analyzed before the presentation of this chapter. In addition, the

studies and literatures are all applicable to the subject of the problem and that will serve

as a background for more findings that will help the researcher.

I. RELATED LITERATURE

A. Foreign

Given the ubiquity of technology in daily life — particularly the internet and

internet-based platforms such as social media sites and smartphone apps — mental

health counselors working today likely will encounter clients who are experiencing

issues that may be directly or indirectly linked to the use of digital media. According to

Dr. Igor Pantic, writing in the literature review “Online Social Networking and Mental

Health,” published by the U.S. National Library of Medicine, there is little doubt that

the internet and social media platforms such as Facebook have had a notable impact on

the way that individuals communicate.

Pantic further explained that a number of recent studies have observed a link

between social media use and certain mental health problems, including anxiety and

depression. Pantic is quick to assert, however, that the studies are by no means

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conclusive and that endeavors to understand the relationship between mental health

and technology remain in their infancy.

Still, it is useful for mental health counselors to have an understanding of the

research and insights into technology’s impact on mental health, which extends to the

positive impacts, as well. After all, drawbacks aside, technology continues to improve

many aspects of daily life for the better, and the arena of mental health is no exception:

there are a number of observable areas in which the development of technology has

helped clients take charge of their mental health care in a positive way.

Despite progress in terms of mental health awareness, journalist Conor

Farrington, writing for the Guardian, explained how mental health care still receives a

notable lack of funding from international governments. For example, Farrington

reported that the per capita expenses on mental health care in industrialized nations

such as the U.S. and U.K. amounts to just over $33, which equates to a little under £33.

The amount is considerably less in developing countries. Consequently, Farrington

argued that technology holds promise as a vehicle for improving access to mental

health care, particularly in nations where such services are elementary at best.

Technology is improving mental health care in a number of ways, Lena H. Sun

explained, writing for the Los Angeles Times, and it is primarily through platforms such

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as apps based on smartphones and computers that can help provide services and

information to clients in a more cost-effective way. For example, Sun explained how

there are now, in addition to smartphone apps that promote mental wellness, certain

platforms available that allow patients to complete courses of cognitive behavioral

therapy online. In her article, Sun profiled a British-based service known as the Big

White Wall, which has been endorsed by the U.K.’s government-funded National Health

Service. Big White Wall is an online platform that enables users living with mental health

problems such as anxiety and depression to manage their symptoms from home via

tools such as educational resources, online conversations and virtual classes on issues

of mental health. The efficacy of Big White Wall is conspicuous — Sun reported on a

2009 study that found that a vast majority of the service’s users —some 95 percent —

noted an improvement in their symptoms.

https://onlinedegrees.bradley.edu/blog/how-does-technology-affect-mental-health/

B. Local

Mental health issues are the leading impediment to academic success. Mental

illness can affect students’ motivation, concentration, and social interactions—crucial

factors for students to succeed in higher education. The 2019 Annual Report of the

Center for Collegiate Mental Health reported that anxiety continues to be the most

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common problem (62.7% of 82,685 respondents) among students who completed the

Counseling Center Assessment of Psychological Symptoms, with clinicians also

reporting that anxiety continues to be the most common diagnosis of the students that

seek services at university counseling centers. Consistent with the national trend, Texas

A&M University has seen a rise in the number of students seeking services for anxiety

disorders over the past 8 years. In 2018, slightly over 50% of students reported anxiety

as the main reason for seeking services. Despite the increasing need for mental health

care services at postsecondary institutions, alarmingly, only a small 0070ortion of

students committing suicide contact their institution counseling centers, perhaps due to

the stigma associated with mental health. Such negative stigma surrounding mental

health diagnosis and care has been found to correlate with a reduction in adherence to

treatment and even early termination of treatment.

The COVID-19 pandemic has brought into focus the mental health of various

affected populations. It is known that the prevalence of epidemics accentuates or

creates new stressors including fear and worry for oneself or loved ones, constraints on

physical movement and social activities due to quarantine, and sudden and radical

lifestyle changes. A recent review of virus outbreaks and pandemics documented

stressors such as infection fears, frustration, boredom, inadequate supplies, inadequate

information, financial loss, and stigma. Much of the current literature on psychological

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impacts of COVID-19 has emerged from the earliest hot spots in China. Although

several studies have assessed mental health issues during epidemics, most have

focused on health workers, patients, children, and the general population. For example,

a recent poll by The Kaiser Family Foundation showed that 47% of those sheltering in

place reported negative mental health effects resulting from worry or stress related to

COVID-19. Nelson et al have found elevated levels of anxiety and depressive

symptoms among general population samples in North America and Europe. However,

with the exception of a few studies, notably from China, there is sparse evidence of the

psychological or mental health effects of the current pandemic on senior high students,

who are known to be a vulnerable population. Although the findings from these studies

thus far converge on the uptick of mental health issues among senior high students, the

contributing factors may not necessarily be generalizable to populations in other

countries. As highlighted in multiple recent correspondences, there is an urgent need to

assess effects of the current pandemic on the mental health and well-being of senior

high students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473764/

II. RELATED STUDIES

A. Foreign

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 During the 1990s the physical and mental health of students in Europe and the

Unites States were an emergent subject of research (Kolbe, 1993; Nauta et al., 1996;

Symons et al., 1997). Findings suggest that students suffer from more health-related

complaints than their non-studying peers (Nauta et al., 1996). These results are in

conflict with the common knowledge that young and educated people would benefit

from a significantly better health status compared to non-studying peers (Boot et al.,

2007). Likewise, findings of previous research on documented treatment records in the

Netherlands has shown that the amounts of students visiting a doctor with

psychosomatic complaints was smaller than the amount of non-studying peers reporting

psychosomatic complaints (Meijman, 1988). However, the evidence is growing for the

relatively poor health status of students compared to non-studying young adults of the

same age (Boot et al., 2007; Stewart-Brown et al., 2000; Vaez et al., 2004).

Non-help-seeking behavior might be the explanation for the discrepancy between

the documented treatment records and reported health problems of students. According

to research on health problems among Dutch students, a significant amount of students

does not seek professional help for their health-related problems (Boot et al., 2007;

Nauta net al., 1996). Recent studies support these findings and additionally found that

non-help-seeking behavior is reported especially by students suffering from mental

health complaints (ASVA Studentenunie, 2010; Rosenthal & Wilson, 2008; Verouden et

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al., 2010). Furthermore, Boot (2007) and Nauta (1996) reported more surprising findings

such as the association between physical complaints and mental health problems and

the impact of health-related problems on study progress. Many recent studies show

similar results suggesting that mental health problems among students relate to study

progress, since students feel limited in their daily activities and experience feelings of

stress that cause their study results to decline.

https://www.huisartsenamsterdam.nl/wp-content/uploads/2015/08/Research-report-E.-

Smit-17-07-2015.pdf

B. Local

School routines are important coping mechanisms for young people with mental

health issues. When schools are closed, they lose an anchor in life and their symptoms

could relapse. “Going to school had been a struggle for [some children with depression]

prior to the pandemic, but at least they had school routines to stick with”, said Zanonia

Chiu, a registered clinical psychologist working with children and adolescents in Hong

Kong, where schools have been closed since Feb 3. “Now that schools are closed,

some lock themselves up inside their rooms for weeks, refusing to take showers, eat, or

leave their beds.” For some children with depression, there will be considerable

difficulties adjusting back to normal life when school resumes.

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 Children with special education needs, such as those with autism spectrum

disorder, are also at risk. They can become frustrated and short-tempered when their

daily routines are disrupted, said psychiatrist Chi-Hung Au (University of Hong Kong,

Hong Kong, China). He advised parents to create a schedule for their children to reduce

anxiety induced by uncertainty. With speech therapy sessions and social skills groups

suspended, he cautions that stopping therapy can stall progress, and children with

special needs might miss their chance to develop essential skills. He points out that

creative ways, such as online speech and social skills training, are needed to make up

for the loss.

Many countries are postponing or cancelling university entrance exams. In Hong

Kong, the authorities made a last-minute decision on March 21 to push back the

Diploma of Secondary Education (DSE) exams, which were scheduled to start on March

27, by a month to April 24. According to a poll by the student counselling group Hok Yau

Club in March, 2020, over 20% of the 757 candidates surveyed said their stress levels

were at a maximum 10 out of 10, even before the postponement was announced. 17-

year-old DSE candidate Yoyo Fung has been experiencing loss of appetite and sleep

problems, and said she found the uncertainties of whether the exams could be delayed

further stressful. “I have a huge wave of fear that I might contract the virus and thus

cannot make it to the exams. Staying healthy has become another stressor”, she said.

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 Meanwhile, college and university students are stressed about dormitory

evacuation and cancellation of anticipated events such as exchange studies and

graduation ceremonies. Some lost their part-time jobs as local businesses closed.

Students in their final years are anxious about the job market they are going to enter

soon. “College students […] are more vulnerable than we think, especially with the

current academic and financial burden”, said Chiu.

Social distancing measures can result in social isolation in an abusive home, with

abuse likely exacerbated during this time of economic uncertainty and stress. Jianli

County in Hubei province, China, has seen reports of domestic violence to the police

more than triple during the lockdown in February, from 47 last year to 162 this year.

Increased rates of child abuse, neglect, and exploitation have also been reported during

previous public health emergencies, such as the Ebola outbreak in west Africa from

2014 to 2016.

However, not much is known about the long-term mental health effects of large-

scale disease outbreaks on children and adolescents. While there is some research on

the psychological impact of severe acute respiratory syndrome (SARS) on patients and

health-care workers, not much is known about the effects on ordinary citizens. Evidence

is especially scarce in children and adolescents. “This is an important gap for research”,

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Au said. COVID-19 is much more widespread than SARS and other epidemics on a

global scale. As the pandemic continues, it is important to support children and

adolescents facing bereavement and issues related to parental unemployment or loss of

household income. There is also a need to monitor young people's mental health status

over the long term, and to study how prolonged school closures, strict social distancing

measures, and the pandemic itself affect the wellbeing of children and adolescents.

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30109-7/fulltext

III. SYNTHESIS

The impact of technology has extended into the realm of health care, and it is

clear that technology also is making positive changes in terms of mental health care.

Research has indicated, however, that the very tools that can help alleviate mental

health issues, such as smartphone apps, may be linked with the experience of mental

health problems in different contexts. As Pantic stressed, more research is needed

before definitive conclusions are drawn. Still, for mental health counselors entering the

field, a comprehensive understanding of the nuanced relationship between technology

and mental health is necessary for effective practice. Counselors are compelled to

expand their technological competencies but always in compliance with their respective

ethical guidelines and the rule of law.

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