JMIR Publications

ABSTRACT

Background:

Barriers to mental health assessment and intervention have been well documented within the South African context, both in urban and rural settings. Internationally, evidence has emerged for the effectiveness of technology and, specifically, app-based mental health tools and interventions to help overcome some of the barriers to adequate mental health assessment and treatment. There is little research on digital interventions specific to the South African context and mental health.

Objective:

The present pilot study investigated the feasibility and effectiveness of the Vimbo app, a self-guided, digital intervention for common mental health difficulties, including depression and anxiety, within a South African context.

Methods:

This pilot study employed a naturalistic, single-arm design utilising multiple repeat measures administered in-app over 12 weeks. 112 Participants were recruited through the South African Depression and Anxiety Group (SADAG) via their support lines and peer-support groups. In addition, we ran adverts on social media platforms, including Facebook and Instagram. The study sample population were all South African citizens over the age of 18 years who have access to an Android phone and feel comfortable using the app in English. All data analysis was conducted using IBM SPSS Statistics software.

Results:

Primary outcome measures used include the Patient Health Questionnaire 9 (PHQ-9), General Anxiety Disorder 7 (GAD-7), and the Work and Social Adjustment Scale (WSAS). Results showed that participants indicated multiple variances of depressive and anxiety symptoms and severity. A review of the differences between entry and exit scores (defined as the last complete set of measures submitted in-app) indicates improvements in all outcome measures. Furthermore, overall (N= 69 excluding incorrect treatment), 13% of users met reliable recovery (9/69), 14.5% saw reliable improvement (10/69), 24.6% deteriorated (17/69), 29% had no change (20/69), and 18.8% had initial scores too low to meet criteria (13/69). Results showed improvements across all measures, including the PHQ-9, GAD-7 and WSAS. Although statistically significant improvements were only observed for the PHQ-9 in the clinical cohort, results from clinical recovery and reliable change indices offer further support for the clinical significance of the app.

Conclusions:

Results indicate that the continued exploration of using app-based interventions to support assessing and treating depression and anxiety within the South African context is warranted and necessary. Future studies should aim to examine and explore the use of technology and, specifically, app-based interventions in assessing and treating mental health difficulties to improve barriers to accessible and effective mental health care.