Digital psychiatry in low-and-middle-income countries: New developments and the way forward

Abstract

Low- and middle-income countries (LMICs) bear the greater share of the global mental health burden but are ill-equipped to deal with it because of severe resource constraints leading to a large treatment gap. The remote provision of mental health services by digital means can effectively augment conventional services in LMICs to reduce the treatment gap. Digital psychiatry in LMICs has always lagged behind high-income countries, but there have been encouraging developments in the last decade. There is increasing research on the efficacy of digital psychiatric interventions. However, the evidence is not adequate to conclude that digital psychiatric interventions are invariably effective in LMICs. A striking development has been the rise in mobile and smartphone ownership in LMICs, which has driven the increasing use of mobile technologies to deliver mental health services. An innovative use of mobile technologies has been to optimize task-shifting, which involves delivering mental healthcare services in community settings using non-specialist health professionals. Emerging evidence from LMICs shows that it is possible to use digital tools to train non-specialist workers effectively and ensure that the psychosocial interventions they deliver are efficacious. Despite these promising developments, many barriers such as service costs, underdeveloped infrastructure, lack of trained professionals, and significant disparities in access to digital services impede the progress of digital psychiatry in LMICs. To overcome these barriers, digital psychiatric services in LMICs should address contextual factors influencing the delivery of digital services, ensure collaboration between different stakeholders, and focus on reducing the digital divide.

Keywords: Digital psychiatry; Low-and middle-income countries; Developments; Mental health

Core Tip: Given the substantial mental health burden and treatment gap in low- and middle-income countries (LMICs), there is a pressing need to implement digital psychiatric services to augment conventional mental healthcare. LMICs have traditionally lagged in this area, but there have been some encouraging developments recently. They include the increasing evidence of the efficacy of digital psychiatric interventions and the growing use of mobile technologies to provide mental health services and optimize task-shifting. However, there are many gaps in the delivery of digital psychiatric services, which need to be overcome by efficiently organizing these services to improve mental healthcare in LMICs.