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Digital Mental Health Interventions for Young People in Rural South Africa: Prospects and Challenges for Implementation

The growing access to mobile devices in South Africa has the potential to increase access to mental health care services through digital platforms. However, uptake of digital mental health interventions may be hampered by several factors, such as privacy, confidentiality, informed consent, and affordability. This study identified the prospects and challenges of implementing a mobile phone-based mental health intervention for young people in Ingwavuma area.

International Journal of Environmental Research and Public Health

Abstract

 

Globally, most young people living with mental health conditions lack access to mental health care but have access to a mobile device. The growing access to mobile devices in South Africa has the potential to increase access to mental health care services through digital platforms. However, uptake of digital mental health interventions may be hampered by several factors, such as privacy, confidentiality, informed consent, and affordability. 

 

This study identified the prospects and challenges of implementing a mobile phone-based mental health intervention for young people in Ingwavuma area. Data were collected from 93 young people in three villages purposefully selected in Ingwavuma area. Participants included in the study were aged 16–24. Data were collected through a questionnaire. Thematic and descriptive analysis was performed on the qualitative and quantitative data, respectively. Mental health education was low, with only 22% of participants having received prior education on mental health. About 50% of the participants had come across a mental health app, but none of them had used any of these apps; 87% of participants had Internet access; 60% preferred to use social media to contact a health worker; and 92% suggested that use of digital apps would improve mental health literacy among young people. 

 

Barriers to access of digital mental health interventions were identified as the high cost of data, restrictive religious beliefs, limited privacy, lack of native languages on most digital platforms, low digital literacy, and complicated user interface. In uMkhanyakude, uptake of digital mental health apps among the young people was low. We recommend that, developers create context-specific digital applications catered for young people from different cultural backgrounds. Socio-economic issues such as affordability also need to be addressed in developing these tools.

Key Takeaways

 

  • “Approximately one in every six South Africans may develop a common mental disorder (depression, anxiety, or drug use disorder) [8]. The South Africa Stress and Health survey revealed a 16.5% 12-month prevalence of common mental disorders (CMDs) which included anxiety, mood, impulse control and substance use disorders [9]”
  • “The COVID-19 pandemic led many health policy makers to recognize the need for accessible mental health support in rural and urban areas [12]. Albeit disastrous, the pandemic also led to the increased use, and adoption of digital health services [13]. Currently, South Africa has a shortage of mental health care workers and a low uptake of mental health services. The use of mobile phones and social media platforms can provide a solution in closing the gap between health facilities and patients needing mental health support. “
  • “In sub-Saharan Africa the treatment gap for people with mental, neurological and substance abuse disorders is vast with only 10% of these people receiving treatment [26]. We found that there was a need for increasing mental health literacy for young people (preferably) using accessible online platforms such as social media. Young people could benefit a lot if they were taught about mental health on their social media platforms.”
  • “We did not come across any apps, or IT based interventions produced in South Africa meant to be used directly by young people. This is a challenge that needs to be addressed, because we realize that most mental health apps in the market are not tailored for African young people. “
  • “There is a need to make these social media-based interventions culturally relevant, free to access, private and user-friendly in order to increase use by young people.”
  • “Post the COVID 19 era, many people and health institutions are considering investment in more web-based solutions for helping patients, and it is therefore key to understand what works for young people and what does not. This study provided this information in the context of a rural setting.”

 

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