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.
Highlights
Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings
We describe some emerging trauma-related technology interventions, and identify some key challenges related to their cultural adaptation, getting them in the hands of trauma survivors, using them to help build the sense of community and capacity for social advocacy that underpin mental health, and developing the methods and systems for implementation of technologyfacilitated mental health response
Given that strengthening of sense of connectedness and social support is seen as an essential principle of intervention after mass trauma (Hobfoll et al 2007), that social media is widely used in low- and middle-income countries (LMICs) and following disasters, it will be helpful to explore further how social media might be used to increase support for trauma survivors and how social media interventions might be further developed
Summary
To improve responses for trauma survivors in the face of such major human resource limitations, it will be necessary for less specialized community workers and family members to help deliver mental health services (Padmanathan & Silva, 2013). This ‘task-sharing’ approach is well underway and represents a paradigm shift (Collins et al 2011; Rosen et al 2016). Interventions like CPT, developed and tested in high-resource environments, are likely to be effective, they require intensive training and significant time to deliver The Common Elements Treatment Approach (CETA; Murray et al 2013) has shown promising results for treatment of symptoms of anxiety, depression, and PTSD in Burmese refugees (Bolton et al 2014a, b) and survivors of systematic violence in Southern Iraq (Weiss et al 2015)
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