A lifeline in your pocket: closing the mental health care gap
by Jon Eddy
Have you used your mobile for health lately?
If so, you’re in good company. Whether a ping on your wrist reminds you to take a break from work, or whether you shared the GPS coordinates of your morning run with your social media followers, it’s no secret that more and more of us are hooked on health apps. In 2015, there were more than 3bn downloads of health apps from major apps stores worldwide, in a market with a predicted price tag of USD 59.15 billion by 2020.
While it’s not always clear from the app store titles, mental health is part of the mix: mood trackers remind us to identify and modify our behavior; soothing meditation audio teaches us to disconnect from everyday stressors, and brain training apps promise to keep our minds on point. If we believe the app store reviews, many of us find these tools helpful. Still, most of us value mobile devices as a trivial extra when it comes to health, and especially mental health: nice to have, but certainly not a replacement for face to face, professional care and not particularly helpful in a crisis.
But in low income countries, networked devices have a crucial role to play, and it’s one where the stakes could not be higher. The challenges of delivering mental health care in developing countries are, unsurprisingly, many and complex. Physicians may be fewer in number and spread out further than in the developed world, leaving conditions undiagnosed and patients without access to treatment. Geographic conditions, poverty and economic considerations all limit access to medical practitioners, and the stigma attached to mental health conditions, in particular, can stop families seeking help. War and natural disaster leaves a legacy of Post-Traumatic Stress Disorder (PTSD) which frequently remains untreated, even when other basic needs are being met. It is clear there is much to be done.
Bangladesh has historically suffered from the most deadly cyclones on record, with much of the country’s poorest population concentrated in flood-afflicted areas. 26% of all people in Bangladesh live below the poverty line, and making the most of limited healthcare resources is a pressing necessity.
A recent innovation from VimpelCom’s operating company Banglalink, in partnership with Synesis IT, gives us a glimpse of what’s possible. For the first time in Bangladesh, subscribers have 24/7 access to expert counsellors and clinical psychologists, simply by using their mobile phone. With 14.5 million adults and nearly 20% of 12 – 17 year-olds living with some form of mental disorder, mobile can provide an effective way to scale the country’s precious resources.
And as smartphone adoption and network development grows, the possibilities become increasingly interesting. An open source project from Northwestern University examines the future application of the smartphone as a diagnostic tool, using onboard sensors to monitor speech patterns, record movement, track sleep and register the wearer’s heartbeat. Connected devices offer a frictionless way for patients to self-report symptoms, receive timely first interventions and streamline precious medical human resources. While not a substitute for the care of a qualified practitioner, apps can allow otherwise disenfranchised patients to benefit from a myriad of services, like cognitive behavioral therapy, educational resources and peer support groups.
While there is much still to be done, the potential role for services like these in the mental health arena is promising. Mobile technology can play a vital role in servicing vulnerable people, encouraging those affected to seek treatment, and providing public education that lessens persistent stigmas.