The ethics of online screening for mental health in South Africa: A systematic review

Abstract

Mental health care in many low to middle-income countries like South Africa is often under resourced. Many individuals in these countries have access to the internet and often use this as a first source to search for information. Hence the possibility for online screening of mental health holds the promise of early detection and intervention. However, there are no clear guidelines for the ethics of online screening for mental health. This study aims to explore the literature in an attempt to explore existing guidelines on online screening with a view to formulating recommendations for a more universally applicable standard for online screening of mental health. A systematic review method was used to explore the literature. Articles were obtained from six electronic databases from 1970 to 2019. Through the use of the PRISMA method 12 articles met the inclusion criteria. There was only one article that made specific reference to ethical considerations regarding online screening instruments, whilst the remaining 11 made reference to some pertinent ethical considerations for online screening of mental health. Using a thematic analysis, six core themes were identified across the articles which covered online screening, namely modes of tests, psychometric properties of the tool, issues of consent, accuracy of results, feedback and test security. These were aspects that needed to be addressed over those already in place for pen-and-paper screening tools. The results are used to provide recommendations for ethical guidelines for the online screening of mental health.