Digital tools to build capacity of non-specialist workers in delivering mental health interventions: Experiences of its development and use within three research projects in diverse community settings in India

Most individuals living with mental illness globally, including India, do not have access to care. Non-specialist workers can play an important role in detecting and treating mental disorders and digital platforms hold the potential to support them in this role. Emerging digital technologies such as smartphones could be harnessed for frontline workers, including non-specialist workers and other lay persons, in delivering evidence-based psychological programs for mental health problems, especially in resource-constrained settings. The current work describes the experiences of three research projects in developing and using digital tools to support non-specialist workers in bridging the care gap for mental health disorders across diverse settings in India. Sangath, a not-for-profit, is leading three innovative projects using digital technologies to 1) train frontline providers to deliver a brief psychological treatment for depression in primary care; 2) train non-specialist workers to provide brief trans-diagnostic psychological interventions to adolescents for emotional and behavioral problems in school settings, and 3) train frontline workers and non-specialist workers to provide a home-delivered parent-mediated intervention to families of children with autism. These projects have resulted in the development and testing of a suite of digital tools targeted at non-specialist workers. These include a Learning Management System available online and via a smartphone app to facilitate remote training (Sangath Learning); an Electronic Medical Records system available online and via a smartphone app providing secure recording and storage of patient data (Sangath Records); and an online Peer-to-Peer Supervision system offering providers remote access to communicate with peers in virtual classrooms and discussion forums for problem-solving and feedback along with supportive supervision (Sangath Groups). Ongoing efforts are needed to evaluate the effectiveness, cost-effectiveness, and sustained impact of digital tools for training non-specialist workers in the delivery of mental health care. In view of the COVID-19 pandemic, several governmental and health organizations introduced new policies regarding the requirement of remote delivery of mental health interventions.