Submission ID 130879
| Issue/Objective | Adolescent mental health represents one of the largest unaddressed treatment gaps in global public health, exceeding 80-90% in LMICs. Digital mental health interventions (DMHIs) are widely promoted as scalable solutions, yet investment decisions are routinely made without a coherent, youth-focused, LMIC-specific evidence base. This study aimed to map and critically synthesize available evidence on DMHIs for adolescents and young people (AYP) aged 10-24 years across LMICs, with explicit attention to implementation realities, equity dimensions, and health system integration, the dimensions most consequential for scale but least represented in existing reviews. |
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| Methodology/Approach | An AI-assisted rapid evidence synthesis was conducted across PubMed/MEDLINE, PsycINFO, EMBASE, Global Health, Google Scholar, and grey literature sources (WHO, UNICEF, World Bank), covering 2014-February 2025. AI decision-support tools were deployed strictly for organizational functions , title/abstract screening and semantic code clustering with all inclusion decisions and interpretive judgements made exclusively by the human researcher. This governance model is itself presented as a replicable framework for responsible AI use in global health research. Twelve studies met the eligibility criteria and were subjected to descriptive evidence mapping and six-step inductive thematic synthesis. |
| Results | Five evidence themes emerged. Clinical effectiveness is moderate and short-term: guided CBT-based interventions reduce depression and anxiety symptoms, but follow-up rarely exceeds 12 weeks and attrition is high in self-guided arms. Engagement not technology is the primary predictor of benefit: hybrid human-digital models consistently outperform self-directed tools across all included studies. Implementation barriers are structural and persistent: mobile data costs, connectivity instability, digital literacy gaps, and absent regulatory frameworks systematically limit access. The equity deficit is severe: early adolescents aged 10-14, rural populations, out-of-school youth, and lower-income groups are nearly absent from the evidence base despite bearing the highest burden. Scalability is contingent on health system integration that does not yet exist in most LMIC policy environments. |
| Discussion/Conclusion | The evidence landscape for DMHIs in LMICs reflects a systemic inversion: the adolescents most studied face the fewest barriers; those with greatest need are least represented. This is not a technology problem, it is a research design problem, a governance problem, and a health systems problem. Scale-up based on current evidence risks reproducing the inverse care law in digital form, preferentially benefiting the already-advantaged. Realizing the genuine promise of DMHIs demands equity-by-design from the outset, task-shifted hybrid delivery models embedded within national health systems, regulatory frameworks that do not yet exist, and a research agenda reoriented toward early adolescents, rural settings, and long-term outcomes. The conference theme: restoring commitment to equity in a fragmented world maps directly to this gap: fragmentation is precisely what prevents DMHI evidence from translating into equitable impact. |
| Presenters and Affiliations | Amina Ibrahim National Open University of Nigeria Timothy Imanobe Oliomogbe DIgital Innovation School of Health Amina Ibrahim National Open University of Nigeria |
