Digital technology for management of severe mental disorders in low-income and middle-income countries.

Merchant, Rutvij; Torous, John; Rodriguez-Villa, Elena; Naslund, John A

PURPOSE OF REVIEW Increasingly, digital technologies, especially mobile telecommunications and smartphone apps, are seen as a novel tool for managing severe mental disorders (SMDs) in low-income and middle-income countries (LMICs). However, there is a need to identify best practices in the use of digital technologies to effectively reach, support, and manage care for patients living with SMDs. In this review, we summarize recent studies using digital technology to manage symptoms and support clinical care for this patient population and discuss new opportunities to advance digital psychiatry research and practice in LMICs. RECENT FINDINGS Studies evaluating digital interventions for clinical populations living with SMDs in LMICs are limited. Yet, across recent articles surveyed, digital technology appears to yield diverse benefits for this at-risk patient population. These benefits include improved medication adherence, appointment adherence, reduced instances of relapse, and fewer re-hospitalizations. SUMMARY Continued rigorous research evaluating effectiveness and cost-effectiveness of digital technologies in reaching, treating, and managing symptoms and supporting clinical care for patients with SMDs in LMICs is vital. The urgency for remote approaches for delivering specialized psychiatric care is particularly pronounced because of the immediate and long-term impact of the coronavirus (COVID-19) pandemic on access to in-person services. Future research should emphasize participatory approaches rooted in a process of codesign with target users, in order to achieve clinically effective remotely delivered digital mental health interventions.