While there is low technological usage in Pakistan, the telecommunications industry has seen a rapid increase in the number of mobile-cellular subscribers. At the end of 2011, 110 million people used mobile phones; up from the 300,000 people who used them in 2,000. Almost every household has access to at least one mobile phone. This provides a unique opportunity for the implementation of mHealth in Pakistan, allowing cost-effective, efficient and improved access to mental healthcare-related information.
Through the mHealth component of our program, large volumes of people will be screened quickly by trained Community Mental Health Workers (CMHW), using a mobile app . Accurate electronic medical records will be maintained in this manner. Individuals who screen positive for depression/anxiety will be referred to the CMHWs, who will provide CBT and IPT-based treatment in a structured format on a weekly basis. At the time of screening, all individuals will be asked if they wish to receive positive support SMS messages. Patients who are willing to receive therapy will also be enrolled in an interactive SMS program with reminders about their weekly appointments and regular questions about their well-being, on a scale. If they respond with a higher scale, the CMHW is immediately notified and will contact the person immediately and ask if they would like to schedule an appointment for the next day. This method will allow for a community-based triage model.
The CMHWs responsible for screening and treatment will be recruited from the communities in which the team already works, to allow for easier access to and familiarity with people. They will receive a basic counseling training on how to perform first-line counseling therapy on patients suffering from depression. They will also conduct regular mental health awareness-raising sessions in the community as well.
A mental health advisory group will be formulated to oversee the technical aspects of the program and provide strategic direction to the program. This group will comprise of experts with extensive experience in mental health, community work and information technology.