MentalTech for Refugee Situations: A Force Multiplier for Mental Health Interventions Delivery?

Recently while reflecting on the almost daily news of the growing refugee crisis emerging in many places around the world and the prospect of its growth owing to economic, climate and military dislocation, I wondered about how mentaltech is being leveraged in this context. According to the United Nations High Commission for Refugees, as of 2016, there are 65.6 million forcibly displaced people in the world. That is the population of the United Kingdom as well as of France. It is also understood that refugees are 10 times more likely to have PTSD than the general population.

For purposes of brevity, I will refer you to a number of references at the bottom of this post related to statistics about the magnitude of the global refugee crisis and let me say its vexingly gah!!!

MentalTech’s Value for Refugee Situations

The value mentaltech can bring to such situations are several:

1. Narrowing of the client-treator time-space gap between traumatized, anxious and depressed refugees and the mental health professionals and workers, via teletherapy and mobile apps.

2. Access to human- & robot-led cognitive-behavioral therapies to a greater number of the suffering, 24/7, than could be served by locally available resources, via mobile apps, messaging, chatbots and digital games. An additional benefit is that such access can be offered anonymously protecting the identity of refugees in stigmatizing situations.

3. Accelerated, broader and ongoing training of local healthcare workers and caregivers in mental therapeutic techniques which make for an improved mental health support network in refugee camps, via mobile websites, chatbots and messaging, both video and typed. In this educational application, it is important to note the power of digital content in aliterate (video, infographics, comics, audio), gamified and indigenized (based on religion, culture, gender, etc.) forms to strengthen the educational process of comprehension and activation.

4. Potentially more accurate assessment and monitoring of population-level mental health states, and even abuses and social determinants of health, to inform more effective and timely individual- and population-level intervention using mobile apps, big data, and AI applications.

These 4 come most readily to mind and I am sure there are others. All these applications represent a force multiplier amplifying the effects of necessary elements of effective population mental health interventions. Please comment if you believe I have missed any.

MentalTech’s Risks for Refugee Populations

Now like everything in MentalTech, where there is light there is also shadow, and so we think about deployments in refugee situations it is important to consider the risks of:
1. identity and data security, and particularly in stigmatizing contexts

2. the digital divide as it relates to bandwidth, tech ownership, indigenous (and unbiased) app, content and AI design, etc.

3. inadequate human support resources to address the human engagement needs that technology can never substitute for in any mentaltech scenario

Examples of MentalTech in Refugee Situations

In research, I have been able to find two instances. I am sure there are more that I have not been able to locate and I really appreciate if any of our readers can point out others they know of.

1. X2AI, a mentaltech known for its chatbot, Tess, programmed its chatbot to provide CBT support to Syrian refugees as an application, Karim AI.

2. Project HOPE, a non-profit focused on helping local healthcare workers around the world in addressing maternal health, pediatric care, infectious diseases and disaster recovery, deployed a digital game project for Syrian refugees in Turkey to improve their Turkish language proficiency, executive functions, and coding skills while decreasing their sense of despair and correspondingly increasing their hope.

3. Hau Therapeutics, a mentaltech firm providing effective, on-demand, multi-lingual and scaled mentaltech interventions via multiple therapy models including Trauma-Focused Cognitive Behavioral Therapy. In particular, one of their offerings is targeting refugee youth experiencing anxiety and are eligible for mental health services in refugee camps.

Though we have not been able to identify the tech company behind it, we did find, in the literature a case of SMS deployed for refugee mental health support in assessing depressive symptoms in South Africa, showing results comparable to face to face screenings (Tomita, 2016). Another study we found indicated that among a sample of female Syrian refugees, 41% were open to telepsychiatry. (Jefee-Bahloul H, 2014)

These are great examples of how mentaltech is already being targeted to refugee populations and we can help and hope to see more and more effective applications in this context into the future.

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