Bridging the mental health gap in the digital age

The under-resourced regions (e.g., low-and-middle-income countries) are disproportionally affected by common mental disorders due to the tremendous lack of mental health care service, which is defined as the mental health gap. A series of studies explored potential accessible routes that might facilitate bridging the mental health gap. Minimal psychological intervention is deemed as a potential to increase access to evidence-based mental health care, therefore narrowing the mental health gap. In Chapters 3 and 4, two meta-analyses on the effectiveness of certain types of minimal psychological intervention (i.e., digital psychological intervention, psychological intervention in university campus) on common mental disorders revealed the moderate treatment effect of these interventions in LMICs. Mechanistic and etiological research provided other angles to address the mental health gap regarding providing essential insights to guide innovation in interventions and pinpoint relevant therapeutic paths during the treatment. Chapter 2 takes depression as an example; we scrutinized the prospective longitudinal evidence underlying the leading theories on depression etiology. However, the available evidence is surprisingly scarce. Parallelly, to illustrate the possible paths that the minimal psychological intervention work through, in Chapter 5, a randomized controlled trial of an internet-based behavioral activation program on major depressive disorder guided by lay counselors in Indonesia provided a clear 4 to 6 weeks’ time window for our treatment program to take effect. These studies provided evidence that hopefully will contribute to making mental health care in LMICs more effective and accessible. Much has been done, but far more needs to be done in the future.