Asking for help: the development of a simulation-based mental health application to enhance depression literacy, mental health communication, and help-seeking among Black autistic youth

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Williams, E. D., Vakil, F., Abubakare, O., Latin, A., Ware, L., Nelson, D., & Smith, M. J. (2026). Asking for help: the development of a simulation-based mental health application to enhance depression literacy, mental health communication, and help-seeking among Black autistic youth. Frontiers in Psychiatry, 17, 1766641-1766641. https://doi.org/10.3389/fpsyt.2026.1766641

Publication date: 1 Apr 2026 Added to AutiHub: 4 Jul 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
7
Publication authors identified as autistic
1 / 7 (14.3%)
  1. Ed-Dee Williams
  2. Fatima Vakil
  3. Oluwatobi Abubakare *
  4. Angelina Latin
  1. Lauren Ware
  2. David Nelson
  3. Matthew J. Smith

Abstract

Black autistic youth experience disproportionately high rates of depression and face intersecting barriers such as racial discrimination, stigma, and limited access to care, yet few interventions address their needs. This study introduces Asking for Help (A4H), a culturally responsive, simulation-based intervention designed to improve depression literacy and help-seeking skills through an e-learning module and interactive conversation practice. Guided by mental health literacy theory, the Theory of Help-Seeking Behavior, the Theory of Planned Behavior, and Disability Critical Theory, A4H was developed using community-engaged and user-centered design principles. Usability testing employed a mixed-methods design with 32 participants (12 youth, 10 caregivers, 8 specialists) using the System Usability Scale (SUS), Patient Health Questionnaire-9 (PHQ-9), and semi-structured interviews. Black autistic youth reported moderate depressive symptoms (mean PHQ-9 = 14.7) and rated usability slightly below benchmark (mean SUS = 66.2), while caregivers and specialists scored higher (73.5 and 71.0). Qualitative feedback highlighted cultural relevance and immediate feedback as strengths, with recommendations for simplified language, improved navigation, and multimodal supports; emotional safety and trust were critical for engagement. No short-term symptom change was observed, consistent with the formative design. Findings indicate A4H is feasible and culturally responsive but requires refinements before efficacy testing to assess impacts on literacy, help-seeking intentions, and communication skills.

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:39.

Cited references
83
With a DOI
76
Without a DOI, from raw bibliography text
7
4 / 83 (4.8%) cited references include at least one author identified as autistic.
References with data to complete
4 / 83 (4.8%)
References with detected author names
79 / 83 (95.2%)
Without detected author names
4
Without a structured title
2
Without a stable identifier
7
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
641
From DOI or external metadata
641
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
244 / 641 (38.1%) names are linked to an author already present in AutiHub. 397 / 641 (61.9%) names are not yet linked.
Names linked to a person identified as autistic
4 / 641 (0.6%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 4 / 244 (1.6%). Distinct people identified as autistic: 3 / 624 (0.5%).
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