mHealth: Potentials and Risks for Addressing Mental Health and Well-Being Issues Among Nepali Adolescents

Abstract

Adolescents are slowly being recognized as a generation, worldwide, that may require different policy approaches to improve staggering statistics on their failing well-being, including mental health. By providing the support to allow the next generation to achieve better mental health outcomes, they are going to be more economically successful and the future economic growth of nations can be better assured. Adoption of mobile-based health interventions (e.g., mHealth) has garnered a lot of attention toward this end. While mHealth interventions are growing in popularity, many researchers/policy-makers appear to have neglected assessing potential (indirect) costs/negative consequences from their use. Evidence from the developed world shows strong associations between extensive cell phone use and negative mental health outcomes, but similar research is minimal in developing world contexts. Additionally, the bulk of work on the outcomes of mobile phone use is studied using a unidirectional approach with blinders to front-end motivations. Using primary data from a large-scale, school-based survey of older adolescents in southwestern Nepal (N = 539), this work investigates such a tension between mobile/smartphone usage as a true mobile health (mHealth) opportunity in Nepal or as a potential problem, introducing additional deleterious well-being effects from over-use. Founded in Basic Psychological Needs Theory (BPNT), robust results of analyses using full structural modeling approaches (and traditional regression-based sensitivity analyses) indicate support for the BPNT framework in explaining statistically significant positive associations between bullying and anxiety, as well as, negative associations between bullying and grit, including evidence to support the mediating role of problematic mobile phone use in these relationships. More than 56% of the sample showed indicators of mild to moderate anxiety and over 10% claim experiences of bullying, coupled with over 75% of the sample scoring above the midline of a problematic mobile phone use scale, all of which motivates the relevance of our findings. Potential policy implications of these findings, and mention of other intriguing avenues for future work are further discussed.

Exploring the demand, practicality, and acceptability of a mental health application intervention for students at a South African university

“…Research has suggested that digital tools are more likely to misdiagnose mental health challenges in users because the diagnostic criteria often overlook subjective experiences (Yan et al, 2022). Conversely, other research has shown a high digital accuracy rate in diagnosing mental health challenges such as mood disorders, eating disorders, and behaviour challenges (Grist et al, 2017;Yilmaz & Bohara, 2021). As the debate around the accuracy of diagnosis using digital tools continues, the finding of this study suggests that an app intervention should be designed in a manner that avoids diagnosing or psychopathologising users.…”

“…Given these challenges, one could argue that a mental health app may not be the best alternative, given the reported negative association between mobile phone use and mental health in this population group. However, extensive global research confirms the potential for mHealth to address mental health challenges among young people, including students (Grist et al, 2017; Haeger et al, 2022; McCloud et al, 2020; Yilmaz & Bohara, 2021).…”

Facilitating engagement of universal school-based digital mental health solutions through user experience: A qualitative exploration

“…Recent and concurrent research efforts have been made that either (a) investigate acceptability of treatment-focused school-based DMHIs among high school students, such as O’Dea et al's study ( 26 ); (b) explore the adolescents’ use and preferences in treatment-focused digital mental health, like Aschbrenner et al's study ( 27 ); (c) explore the perspectives and preferences of young people including—but not focused on—adolescents regarding school-based digital mental health services through conducting a pilot study, for example, Garrido et al's study ( 28 ); (d) explore the experiences of young adults above high school age with non-school-based digital mental health applications, such as Borghouts et al's study ( 29 ); (e) explore the barriers and facilitators of engagement with non-school-based DMHIs for adults above high school age, like studies conducted by Borghouts et al ( 30 ) and Auster-Gussman et al ( 31 ); or (f) discuss the potential benefits and risks of using digital mental health for adolescents, such as works by Cefai et al ( 32 ), Yilmaz et al ( 33 ), and Wies et al ( 34 ). The mentioned studies have been very important and encouraging due to their focus in such sensitive topics and their goals of advancing the body of knowledge pertaining to DMHIs or digital mental health resources in general.…”