The development and use of adolescent mobile mental health (m-mhealth) interventions in low- and middle-income countries: a scoping review

Adult mental health challenges frequently stem from undiagnosed poor mental health earlier in life. With increasing levels of poor adolescent mental health and insufficient health care resources in low- and middle-income countries, mobile mental health may offer expanded service access. Little is known about mobile mental health interventions for adolescents in low- and middle-income countries. Our aim was to review the literature on mobile mental health intervention, development and use for low- and middle-income country adolescents. We searched APA PsycInfo, Web of Science, Psychiatry online, and Ebscohost databases using keywords and phrases. Screening of the 6953 retrieved articles, generated 6 articles that met the inclusion criteria. Arksey and O'Malley's adapted framework was followed using rigorous inclusion criteria and screening by two reviewers. Studies showed high heterogeneity. Two studies used short message service text messaging platforms, one used phone call reminders, two used smartphone applications (WhatsApp or game-based), and one study compared different short message service, web-based and smartphone app offerings. Generally, adolescents had a positive perception of mobile mental health interventions. Helpline messages, peer group sessions, access to a counsellor and games set in real-life environments were some of the preferred contents of mobile mental health interventions. Noted barriers include low personal mobile phone ownership, leading to lack of confidentiality, data costs and limited internet access. While adolescents in low- and middle-income countries find mobile mental health interventions acceptable and supportive, challenges remain. Mobile mental health interventions can potentially overcome barriers associated with face-to-face care, such as high cost and stigma. However, more research is needed to overcome these challenges and build the evidence-base in low- and middle-income countries for this field to grow.