Digital technology for management of severe mental disorders in low-income and middle-income countries

Abstract

Purpose of review Increasingly, digital technologies, especially mobile telecommunications and smartphone apps, are seen as a novel tool for managing severe mental disorders (SMDs) in low-income and middle-income countries (LMICs). However, there is a need to identify best practices in the use of digital technologies to effectively reach, support, and manage care for patients living with SMDs. In this review, we summarize recent studies using digital technology to manage symptoms and support clinical care for this patient population and discuss new opportunities to advance digital psychiatry research and practice in LMICs. Recent findings Studies evaluating digital interventions for clinical populations living with SMDs in LMICs are limited. Yet, across recent articles surveyed, digital technology appears to yield diverse benefits for this at-risk patient population. These benefits include improved medication adherence, appointment adherence, reduced instances of relapse, and fewer re-hospitalizations. Summary Continued rigorous research evaluating effectiveness and cost-effectiveness of digital technologies in reaching, treating, and managing symptoms and supporting clinical care for patients with SMDs in LMICs is vital. The urgency for remote approaches for delivering specialized psychiatric care is particularly pronounced because of the immediate and long-term impact of the coronavirus (COVID-19) pandemic on access to in-person services. Future research should emphasize participatory approaches rooted in a process of codesign with target users, in order to achieve clinically effective remotely delivered digital mental health interventions.

Digital Training for Non-Specialist Health Workers to Deliver a Brief Psychological Treatment for Depression in Primary Care in India: Findings from a Randomized Pilot Study

“…Our study aligns with an emphasis in the digital mental health research literature that it is necessary to consider the perspectives of users in order to support adoption, engagement, and sustained use of digital interventions [65][66][67]. Despite the large number of technical challenges that participants mentioned throughout this pilot study, we were reassured by participants' continued interest in learning about the mental health treatment related content.…”

COVID-19 Mobile Apps: A Systematic Review of the Literature

“…Other recent reviews have focused merely on the exploration of COVID-19 mobile apps in app stores in general [ 8 ] or were restricted to apps deployed in specified countries such as the United States, the United Kingdom, and India [ 9 ]. Although there are already related generic COVID-19 information and communication technology surveys [ 10 , 11 ], they focus on specific topics such as contact tracing [ 12 , 13 ]; specialized health sectors like pediatric health care delivery [ 14 ], mental health [ 15 ], epilepsy [ 16 ], and palliative care [ 17 ]; or countries like India [ 14 ], China [ 18 ], and the United Kingdom [ 19 ]. To the best of our knowledge, there has been no other work dedicated to the systematic review of pragmatic studies that have demonstrated the real-life use and evaluation of COVID-19 mobile apps.…”

A Digital Toolkit (M-Healer) to Improve Care and Reduce Human Rights Abuses Against People With Mental Illness in West Africa: User-Centered Design, Development, and Usability Study

“…Digital technology can play an important role in the management of psychiatric illnesses in low- and middle-income countries [ 47 ]. Our multinational team successfully developed and completed the preliminary testing of M-Healer, a novel mHealth intervention designed to be used by healers who provide care to people with psychiatric illnesses in West Africa.…”