Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities

Abstract

Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.

Self-administered EMDR therapy: potential solution for expanding the availability of psychotherapy for PTSD or unregulated recipe for disaster?

“…27 Consequently, many leaders in global mental health have called for urgent action towards the development and evaluation of mobile and internet technologies to overcome these barriers and thus increase access to psychological therapies worldwide. 23 The digital era of healthcare…”

“…In a 2015 survey of 21 emerging and developing countries, a median of 54% reported using the internet and 37% reported owning a smartphone (Pew Research Centre, 2016), 44 and there is a growing body of evidence that treatments using mobile and internet technologies can be feasible and efficacious in LMICs, while increasing the availability and accessibility of mental health services. 23,45 Potential risks and controversies around selfadministered EMDR therapy A session of EMDR therapy can lead to a short-term increase in distress for patients, 46,47 which Francine Shapiro, the founder of EMDR therapy, warned could lead to a transient increase in suicidality in some patients. 47 She explained that this may be due to the resurfacing of dissociated information, emotions and physical sensations.…”

Association Rule Learning Is an Easy and Efficient Method for Identifying Profiles of Traumas and Stressors that Predict Psychopathology in Disaster Survivors: The Example of Sri Lanka

“…Once practitioners know what traumas and stressors are associated with higher risk of psychopathology, they can send out short surveys that ask respondents if they have experienced or are currently experiencing those traumas and stressors that are predictive of psychopathology. Such short surveys could be distributed electronically via internet or mobile technologies, which have been identified as playing a key future role in expanding assessment and treatment of mental illness in post-disaster low-and-middle-income countries [36]. Given their brevity, one would expect to see high rates of response to these surveys.…”

Passive Sensing Data Collection with Adolescent Mothers and Their Infants to Improve Mental Health Services in Low-Resource Settings: A Feasibility and Acceptability Study in Rural Nepal

“…Passive sensing data collection can be especially helpful for health initiatives in low-and middleincome counties (LMIC), which are characterized by limited access to specialty health services and where some populations have low literacy [5]. Combined with effective interventions, passive sensing data collection has the potential to address major public mental health issues in LMIC.…”