Mental Health: Mobile Technology Use in Developing Countries

Cell phone image courtesy MicrosoftIn developing countries, almost everybody has a cell phone, and sometimes two or three to take maximum advantage of network coverage across different carriers. Not all phones are operational all the time; the predominant use of prepaid plans means that sometimes people let their minutes run out until they can afford to reload the phone. But where personal computers are still an anomaly, mobile handsets have become ubiquitous, and for good reason: they’re less expensive than other (computing) devices, increasingly “smart” and multifunctional, and both durable and portable for long and dusty trips from village to city and back again.

Erecting cell booster antenna - Northern Cameroon
Erecting cell booster antenna – N. Cameroon

For these reasons, problem solvers in the Global South turned to mobile technology before it had even caught fire in the North. In the banking industry, mobile payment operations started as far back as 2000, for example. Soon, ideas for mobile solutions for agriculture and education and health care were all popping up, and I’m pleased to see that this is now extending into the mental health arena.

Some of this momentum is being driven by dollars from the Government of Canada. Through an agency called Grand Challenges Canada, it was announced last week that more than seven million dollars has been allocated for 22 global mental health projects worldwide. These projects are delivered by local in-country agencies and institutions (a very important aspect, in my opinion).

Of the initiatives that were chosen for a grant, 13 of them include deployments of mobile phone technologies. Uses will include things such as screening and referral tools, and training and support for lay health workers (defined as those who carry out functions related to healthcare delivery, but have no formal professional or paraprofessional certificate or tertiary education degree).

Port-au-Prince, Haiti
Port-au-Prince, Haiti

The practical reality of mental health care delivery in the developing world is that the majority of services will come through lay health workers. As Grand Challenge’s press release states, there are fewer than 30 psychiatrists for 10 million people in Haiti, and data from other countries would reflect similar ratios. Ramping up the number of professionals in specialty areas takes too long, so community health care workers are the most available and direct way to create a greater availability of services. With mobile technology, these generalists will have more specialized resources at their fingertips, via a device that they probably already own.

The entire list of projects and related links and contacts is available on this Global Mental Health Media Information Sheet. It’s an interesting mix, and the geographic diversity is sure to lead to some unique challenges and results. I plan to follow up on some of them in the future.

Have you run across a mobile application that is designed specifically for mental health? Do you have field experience delivering mental health services in the Global South? All thoughts and feedback is appreciated!

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Haiti photo: Wiki Commons by Marcello Casal Jr, ABr

 

Comments

  1. says

    Really interesting post, Laura. Not sure whether I’ve mentioned this to you before, but have you ever come across the Moodscope website? http://www.moodscope.com is a beautifully simple tool for individuals to keep track of their own mental health, in particular depression, so as to spot a storm coming and to be more aware of what their triggers are. It is free to use at basic level, although there is a paid upgrade option for something fancier. You can also opt to receive a daily motivational post from them by email, which I read every day and find really helpful. I use it on my PC rather than as a phone app, and I’m not sure whether an app exists, but the website is pretty straightforward so might work via a reasonable mobile signal.

    I haven’t suffered from depression for some years, but I’ve kept in touch with this app since my last bout (when my daughter was diagnosed with diabetes, straight after I’d been diagnosed with rheumatoid arthritis – that double whammy was the trigger for me) and I still read their daily messages and find them really helpful.

    It was founded by a guy who lived with severe depression who understood exactly how it feels. Worth checking out for anyone ever touched by depression.
    Debbie Young recently posted…Blog Chain: What Am I Working On?My Profile

    • Laura Zera says

      You know, you did mention it to me, and I checked it out briefly but didn’t go back. Will give it another look, because it might be a good feature for a blog post, too, hey? I didn’t know you have RA, Debbie. My stepmum has it so I know it’s one of those things that requires diligence, just like diabetes. I’m glad that you’ve found some good tools and that things have leveled out for you. xo

    • Laura Zera says

      I actually thought it was kind of random that the Canadian government is funding a bunch of this, but hey, if the money is clean (ha!) then yeah, let’s put it toward projects in areas where they’re lacking!

    • Laura Zera says

      If your loneliness app would include steps for creating connection, then YES!

      I’m guessing that most of the apps out there are for the consumer. I wonder what exists for ‘train the trainer’ stuff and practitioner curriculum.

    • Laura Zera says

      Sometimes it can get pretty silly, all the apps that are out there, but this kind of platform is an amazing thing for people in places who only ever carry a phone!

  2. says

    Very exciting Laura! Thanks for informing us about these wonderful plans. Love that technology can be used for health benefits, especially mental health, and even more that a helping hand is being extended to developing countries. Glad that you plan to follow up as would love to hear more! Especially how the projects translate to positive outcomes over time.
    Jacquie Garton-Smith recently posted…Is excitement a new strategy for writers?My Profile

    • Laura Zera says

      It is exciting, because the key is finding applicable technology, and I think this is on the right track. Lord knows that the developed world has thrown some totally inappropriate junk at the developing world! Thanks for reading, Jacquie.

  3. says

    This was an interesting post, Laura. Now that I read it, it makes perfect sense that people in developing countries would rely more on smart phones than computers. I have this image in my head of a person with three or more phones dangling like a necklace from lanyards on their chest.
    And a shout out to Canada for supporting mental health in places with such great need and few resources.
    Jagoda Perich-Anderson, M.A. recently posted…Ten Quotes on Conflict, Innovation and Mental StrengthMy Profile

    • Laura Zera says

      It’s really funny sometimes when a guy will sit down at the table and spread three phones out in front of him! Thanks for your comment, Jagoda.

  4. says

    Dear Laura. Thanks for this post! Great to see more and more people showing their interest and passion for people with mental conditions in ‘the South’.
    I agree that using the New Technologies could help solving the huge gaps in mental health care and knowledge in low income countries, but I’m afraid that smart phones can’t be ‘the solution’ at this very moment. Although smart phone penetration is growing in low income countries, most people in these countries still rely heavenly on basic cell phones without internet. They still rely on SMS/text messages or voice messages. Apps and smart phone programs are really ‘science fiction’ for these people. Don’t forget that only 40% of the World’s population has access to internet! That means 60% has no access at all!
    So. if one wants to reach people in low income countries, and especially in rural areas like for instance community health workers, one must still seek solutions and applications using basic cell phones (yes, e.g. the old Nokia’s with small display). And use bulk SMS programs, automatic SMS/voice answer software, SD cards (‘secure digital cards’, or sim cards with files on it like video or text), and make sure that the health workers get free air time for calling or messaging back.
    You can see examples in my 2012 blog post ‘A wake up SMS for Global Mental Health: mhealth in 40 short videos’ (http://in2mentalhealth.com/2012/05/07/a-wake-up-sms-for-global-mental-health-mhealth-in-40-short-videos). Although nearly 2 years old, I think the situation has not much changed yet.
    So, apps and smart phones can bring a major breakthrough for mental health care in the North, but the South is not catching up yet. Unfortunately!

    • Laura Zera says

      You’re absolutely right, Roos, and thank you for pointing that out. I’m sure the projects are using the appropriate technologies in the field for the types of phones that are predominant (as they have for mobile payment transfers, agricultural information, etc.). I didn’t mean to make it sound like smart phones were everywhere, but it was misleading that I used a photo of a smart phone for the first image. I think I must change that!

      Thank you for your thoughtful comment. I believe that internet access will continue to be an issue because there is no inexpensive way to deliver it when there isn’t already fiber in the ground, and developing countries are passing on tackling that kind of infrastructure. So then, I guess, the question is whether data services can become inexpensive enough that people will be able to do more with their (smart/smarter) phones over the cellular network. Whereas data prices are still inflated around the world, voice call pricing has come down a ton in the last decade. Hopefully the same will happen for data.

      I looked at your website — you do such interesting work! I hope we have an opportunity to talk more in the future. So nice that you are freelancing with MSF — I have a huge fondness for them as when I was working in some squatter camps in South Africa in the 90s, an MSF team was also working in the area, and they were just fantastic. Really great to work with.

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