#MHForAll Webinar: Digital Mental Health Tools
On Tuesday 28th November, a panel of experts met to discuss the diverse applications of digital mental health tools. They explored how these innovative strategies can bridge service gaps, improve accessibility, and eradicate mental health stigma. We learnt from country case studies in Mozambique, Pakistan, The Philippines, and Bangladesh and discovered how our experts design and implement digital interventions to address local concerns and their potential to offer rights-based support and person-centred care.
Webinar panellists:
Molebogeng Mangoale, Business Development Specialist, Waves for Change, South Africa
Roy Dahildahil, Co-Founder & Executive Director, #MentalHealthPH, Philippines
Duaa Nusrat, Senior Program Manager, Taskeen, Pakistan
Dr. Jana Alagarajah, Technical Lead, YLabs, Rwanda
Pattie Gonsalves, Principal Investigator, Sangath, India
Antonio Suleman, Psychiatrist, Department of Mental Health, Mozambique
Ken Carswell, Technical Officer, Department of Mental Health and Substance Abuse, WHO, Switzerland
Farjana Sharmin, Programme Manager, BRAC, Bangladesh
Dr. John Torous, Director, Digital Psychiatry Division, Beth Israel Deaconess Medical Center; Assistant Professor of Psychiatry, Harvard Medical School, USA
Replay session 1 of 2:
Session notes:
Digital Mental Health Tools in the Philippines
Roy Dahildahil discusses the need to tailor digital mental health interventions to provide rights-based, person-centred care. From his experience working on interventions in the Philippines, he notes that digitalisation is inevitable and advocates for ensuring its safety and accessibility for all individuals. Digital mental health tools have been widely used in the Philippines, including the development of two mobile apps by #MentalHealthPH and the creation of chatbots during the pandemic. He emphasises the significance of involving service users in the development process, ensuring their engagement from inception to completion. Roy expands the scope beyond clinical interventions, advocating for the use of digital tools to raise awareness and promote the general well-being of the population.
Learn more about #MentalHealthPH here: https://mentalhealthph.org/
Successful Digital Interventions in Pakistan
Duaa Nusrat delves into successful digital interventions in Pakistan, noting the substantial shift towards digital health services post-COVID and the increased accessibility they offer. She emphasises the role of helplines and WhatsApp chatboxes in bridging gaps in mental health service provision, particularly for marginalised groups like youth and women. Duaa notes the importance of leveraging social media platforms to destigmatise mental health discussions, highlighting the power of storytelling and the impact of individuals sharing their lived experiences. As these tools continue to evolve, there is a need to integrate diverse perspectives and experiences to ensure digital interventions are effective and appropriate.
Check out Taskeen Health Initiatives programmes here: https://taskeen.org/
Insights from the Latest Systematic Review on Interventions in LMICs
Jana Alagarajah’s insights from a systematic review of digital mental health interventions in LMICs centre around youth-focused approaches. He highlights the efficacy of Cognitive Behavioural Therapy (CBT) interventions targeting depression among young people in resource-constrained settings but identifies a considerable data gap and issues related to adaptability. Jana strongly advocates for a participatory approach in designing interventions, emphasising the need to engage young people in the process. He flags the importance of forging partnerships across sectors and establishing community regulatory mechanisms to support and effectively sustain these interventions.
Find out more about YLabs here: https://www.ylabsglobal.org/
Co-Designing Digital Initiatives with Adolescents in India
Pattie Gonsalves shares lessons from implementing digital tools in India. There are significant existing barriers that prevent youth and adolescents from accessing help due to infrastructure limitations and stigma. She highlights the pivotal role of youth engagement in designing and implementing digital mental health solutions. Pattie highlights initiatives such as a national campaign called "It's ok to talk" and tailored interventions for schools as effective strategies. Her emphasis on co-designing interventions with diverse groups of young people and prioritising sustainability throughout the project cycle underscore the need for inclusive, long-term approaches.
Learn more about Sangath’s work on digital initiatives in India here: https://sangath.in/
E-Mental Wellbeing Tool in Mozambique
Antonio Suleman shares insights from Mozambique's mental health landscape and the development of a Mental Wellness Tool to address the shortage of specialists. He explains the concept of task-sharing, enabling trained individuals to deliver mental health services at district sites. Antonio details the tool's structure, comprising 13 questions utilised by community health workers to identify mental health disorders, with additional questions to categorise these disorders. He emphasises training workers on safety plans and providing interpersonal counselling for common disorders, illustrating the importance of empowering community-level healthcare personnel in addressing mental health challenges.
Find out more about the e-Mental Wellness Tool here: https://ps.psychiatryonline.org/doi/10.1176/appi.ps.202000090
WHO & The Future of Digital Mental Health
Ken discusses the diverse formats of digital mental health tools, encompassing self-help apps and therapeutic sessions via platforms like Zoom. He highlights WHO's recently published recommendations on digital tools, expressing optimism about their potential. However, Ken points out existing barriers, particularly issues regarding the scalability and accessibility of these tools. He suggests prioritising the implementation process, ensuring safe and effective delivery, and integrating these digital tools within the broader framework of existing healthcare services. Looking forward, he sees the evolution of this space as reliant on balancing technological advancements with ensuring widespread accessibility and efficacy.
Check out WHO’s page on innovations in psychological interventions here: https://www.who.int/teams/mental-health-and-substance-use/treatment-care/innovations-in-psychological-interventions
Here are WHO’s updated mhGAP recommendations: https://www.who.int/publications/i/item/9789240084278
Digital Facilitation of Programs at BRAC
Since 2019, the BRAC mental health program has integrated mental health into primary healthcare with the Bangladeshi Government's collaboration, using digital tools for long-term efficacy and scalability. By 2023, the entire program had shifted to digital facilitation, training community health workers and counsellors in mental health primary screening and sensitisation efforts to reduce stigma. All screenings, assessments, and data entry are completed digitally, with community health workers passing on client information to para-professionals if psychosocial support is needed. Despite these innovations, access remains a challenge in rural areas with limited smartphone penetration. The intervention aims to improve scalability and rapid access, particularly in rural locales with limited mental health services due to stigma and resource constraints.
Learn more about BRAC’s projects here: https://www.brac.net/
Machine Learning and the Role of Digital Navigators
John discusses the spectrum of digital tools for mental health, explaining that while AI machine learning can be valuable, not all interventions rely on this technology. Evaluating existing digital interventions, John identified various privacy concerns, high costs, and issues around low efficiency. An open-source research tool has been developed to customise searches based on language and address these concerns. John notes the necessity of human interpretation through a ‘digital navigator’ even with machine learning developments, raising the question of how non-clinicians or individuals with lived experience can assist in this process. Harvard Medical School have now built a clinic where patients receive regular telehealth visits and use apps to augment and supplement care. Digital navigators collect additional info on psychosocial well-being between sessions to provide personalised care without reducing the face-to-face time available in the clinic.
Check out this interactive database to find mental health and brain apps that meet unique preferences: https://mindapps.org/
Here is the LAMP neuropsychiatric research and clinical care management platform: https://docs.lamp.digital/using/assess
Standardising the role of a digital navigator in behavioural health: a systematic review:
https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00152-8/fulltext
Access Digital Health Navigator Training here: https://smiadviser.org/dhn
The Digital Clinic: An Innovative Mental Health Care Delivery Model:https://catalyst.nejm.org/doi/abs/10.1056/CAT.23.0100
