Dr. Richard Mollica, Director of Harvard’s Program in Refugee Trauma, writes, “Specifically, depression is a common mental disorder and one of the main causes of disability worldwide. Globally, about 400 million people of all ages suffer from depression with more women being affected than men (WHO, 2014a).[see article) Estimations may even be worse; Patel et al. (2016) revealed a treatment gap exceeding 90% for common mental disorders and alcohol use disorders in India and China, two relatively well-resourced middle-income countries (Fairburn & Patel, 2016). The lack of a mental health policy, mental health programs and mental health legislation in many countries, as well as limited resources (both financial and human), a limited infrastructure, stigma and shame are important reasons for low uptake and dissemination of mental health care (WHO, 2008; Muñoz et al. 2016).”
The use of information technology to support the delivery of tele-mental health (TMH) is an important component in meeting critical mental health needs of the global population. The World Health Organization (WHO) declared in 2013 that Mental Health will be one of its top priorities in the 21st century because of its global importance; an estimated 450 million people worldwide have mental or behavioral disorders, accounting for 12% of WHO’s global burden of disease. However, it is reported that 75% of people suffering from mental disorders in the Developing World receive no treatment or care.
Telemedicine and TMH, using web technologies, have the capacity to bring evidence-based best practices and interventions in mental health to the under-served and difficult-to-each areas of the world, including post-disaster settings. With internet penetration and mobile phone ownership increasing globally (Pew Research Center, 2016), digital technologies offer a genuine opportunity to overcome several of these barriers. The introduction of smartphones in the 2000s brought the Web literally to our fingertips.
Clinicians quickly recognized the potential of creating interventions that could be delivered digitally, using text, graphics, audio, and eventually video elements. Internet-based websites and mobile applications can have interactive features that allow users to input data that trigger appropriate responses from the program as well as track clinical progress. Digital platforms, including web-based and mobile health applications, are now available to anyone in the world with access to the internet, though language continues to be a barrier.
“Platforms able to connect users to credible and effective digital interventions
for specific health conditions should thus be a high priority.” (see article)
Dr. Ricardo Muñoz
The reality on the ground in many places around the world is that the presence of trained mental health workers (MHW) is limited or non-existent, thus handicapping the usefulness of these new technological approaches. On the other hand, recent meta-analyses clearly show that guided and unguided digital interventions are effective for such disorders as depression, cause less deterioration in users than control conditions, and have even been shown to prevent new episodes of depression.
If research proves that TMH has this ability, then building a digital bridge between underserved, remote populations and the excellent evidence-based mental health resources already available online, as Dr. Muñoz et al argues, makes sense. Once this digital bridge is built, the next step is to enable a local community to close the gap further by giving it multi-lingual tools with which it can adapt the material to its culture and context in order to maximize the materials’ healing potential. This is the mission we undertook in designing and constructing the ARC Process and Platform.
Will Sibert & Tyler Tamaro
 Augusterfera, Eugene F., Richard F. Mollica & James Lavelle. “A review of tele-mental health in international and post-disaster settings”. International Review of Psychiatry, 2015 VOL. 27, NO. 6, 540–546. http://dx.doi.org/10.3109/09540261.2015.1082985
Muñoz, Ricardo F., Denise A. Chavira, Joseph A. Himle, Kelly Koerner, Jordana Muroff, Julia Reynolds, Raphael D. Rose, Josef I. Ruzek, Bethany A. Teachman, Stephen M. Schueller. “Digital apothecaries: a vision for making health care interventions accessible worldwide” mHealth http://dx.doi.org/10.21037/mhealth.2018.05.04