Evidence-Based Social Intervention and Policy Evaluation

Background: COVID-19 has placed extreme pressure on mental health globally, uncovering an imperative need for increased support. Those living in poverty are particularly vulnerable to the psychological burdens accompanying the pandemic. Numerous barriers continue to impede access to mental health services in the developing world (Andrade et al., 2014; Saraceno et al.,2007), however digital technologies offer fresh avenues for supporting people in crisis and may be helpful in improving access to supports. The World Health Organisation (2013) emphasises the scarcity of mental health resources in developing countries; 76% to 85% of people with severe mental disorders receive no treatment in low-income countries. Empirical evidence is urgently required for progress in mental health policymaking (Deady et al., 2017). The WHO notes: "In the absence of thorough documentation and rigorous evaluation of programmes we have too little knowledge about what works. Unless service models can be demonstrated to deliver effective treatments, there is little reason to believe that advocacy efforts will expand mental health services to underserved populations." (Cohen, 2000 p. 32).

Aim: To evaluate the effectiveness of digital mental health interventions in the developing world. By contributing empirical evidence on digital supports, this research will aid policy efforts to expand mental health service provision in underserved populations and help to reduce barriers to mental health resources in low-income countries. Research Question: Are digital psychosocial interventions effective for improving mental health in developing countries? Method: A digital mental health tool usable on any mobile device will be developed in collaboration with Mental Health Innovations for this field experiment. In a randomized control trial, half of participants will be assigned to an early intervention group with remaining participants assigned to a wait-list delayed intervention group. It is hypothesised that mental health outcomes (measured using instruments such as EQ-5D and HDRS) will be improved following the intervention relative to the control group. Due to differences in healthcare resource availability and the relevance of culture in the acceptability of treatments, it is necessary to develop interventions congruent with the context of specific settings (Garcia, 2018). This research will contribute to the development of culturally appropriate, evidence-based, psychosocial interventions improving mental health in communities most in need of support.