JMIR Publications

ABSTRACT

Background:

Digital mental health interventions (DMHIs) are increasingly recognized as drivers for achieving the United Nations' Universal Health Coverage and Sustainable Development Goals, particularly for adolescents in low- and middle-income countries (LMICs). Understanding the design, evaluation, and barriers or facilitators impacting adolescent access to mental health care through DMHIs is essential.

Objective:

This systematic scoping review aims to provide insights into the landscape of DMHIs for adolescents in LMICs.

Methods:

The Joanna Briggs Institute (JBI) scoping review methodology was employed, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) recommendations. Our search strategy incorporated three key concepts: population "adolescents", concept "digital mental health interventions" and context "low-and middle-income countries". We adapted this strategy for various databases, including ACM Digital Library, APA PsycINFO, Cochrane Library, Google Scholar (including grey literature), IEEE Xplore, ProQuest, PubMed (NLM), ScienceDirect, SCOPUS, and Web of Science. The articles were screened against specific eligibility criteria within the time frame of January 2017 to October 2022.

Results:

We analyzed 19 papers focusing on DMHIs for various mental health conditions among adolescents, such as depression, well-being, anxiety, stigma, and suicide ideation. These interventions were delivered in diverse formats, including group delivery, self-guided interventions, with support from mental health professionals, or involving lay professionals. The study designs encompassed a range of methodologies, including randomized controlled trials (RCTs), mixed methods studies, and feasibility studies.

Conclusions:

While there have been notable advancements in DMHIs for adolescents in LMICs, the research base remains limited. Significant knowledge gaps persist regarding the long-term clinical benefits, the maturity and readiness of LMIC digital infrastructure, cultural appropriateness, and cost-effectiveness across the heterogeneous LMIC settings. Addressing these gaps necessitates large-scale, co-designed, and culturally sensitive DMHI trials. Future work should address this.