Do mental health mobile apps work and can they help close Africa’s treatment gap?

Do mental health mobile apps. Many patients go years, decades or even their entire lives with their mental health conditions left untreated. This occurs even more so than with physical health conditions, which patients are more likely to seek treatment for. This mental health treatment gap is apparent in both developed and low- and middle-income countries but even larger in the latter. Research from the World Health Organization (WHO) suggests that the treatment gap for severe mental disorders in low- and middle-income countries can be up to 75 %. The gap is drastically larger in these countries, due to various factors such as cultural stigma, economic impoverishment, and a lack of health care specialists (particularly psychologists and psychiatrists).

The number of psychologists and psychiatrists are too few to effectively serve the population in most sub-Saharan African countries, for example Nigeria. Africa’s strongest economy, Nigeria, has about 200 psychiatrists to its population of 170 million. Most of these health specialists are located in bigger cities, leaving most communities with no medical treatment. 

The lack of effective care affects both patients and their families. When seeking treatment, most people engage traditional, spiritual or religious healers, or their primary physicians. 

Many medical professionals acknowledge that increasing accessibility to mental health care will rely heavily on primary care, who are expected to offer first contact, as well as, provide comprehensive, continuous, and coordinated management, and where necessary prescribe referrals to a higher, more specialised level of care. Some medical professionals also recognise the unique opportunity with smartphone-based mental health apps in facilitating access to mental health treatment from psychologists, psychiatrists and counsellors. “Public health organizations like the UK’s National Health Service (NHS) and the U.S. National Institute of Mental Health (NIMH) suggest mental health apps as cost-effective and scalable solutions to addressing the mental health treatment gap.”1 

Mental health apps are designed differently to target varying psychological disorders. NIMH classifies mental health apps into six categories based on functionality: self-management, cognition improvement, skills-training, social support, symptom tracking, and passive data collection (3). Ease of habit, low effort expectancy, and high hedonic motivation make mobile apps a good choice for psychological treatment. 615M people in Sub-Saharan Africa will subscribe to mobile services by 2025, equivalent to 50% of the region’s population. 4 $155 BN of economic value added will be generated by mobile technologies and services by 2025 in the region. In 2020, transactions on mobile money platforms reached $490 billion as well. Mobile phones adoption is prevalent and continues to grow in Africa making it a viable channel to help health management. Additionally, mobile health apps have been proved to be effective.

“A meta-analysis of 18 randomized controlled trials (RCTs) covering 22 mobile apps revealed that using apps to alleviate symptoms and self-manage depression significantly reduced patients’ depressive symptoms compared to control conditions (g=0.38, P<0.001). They also found that smartphone-based therapies yield the greatest benefits for individuals with mild to moderate, rather than major, depression.”2

Evidence shows that the mental health treatment gap could be effectively addressed in Sub-Saharan Africa with engaged primary care management and smartphone based app solutions. Technology posses the potential to transform accessibility and quality of mental health treatment, but this change requires the science, regulation, and design to ensure efficacy of the apps.

Sources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897664/ 

2. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0911-3

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897664/#r3 

4. https://www.gsma.com/mobileeconomy/sub-saharan-africa/