Improving the Quality of Global Mental Health Services with Digital Tools: Best Practices and Lessons Learned from Rural Nepal

Digital technology has tremendous potential to improve global mental health (GMH) services. However, while much attention has focused on expansion of access to care, relatively less is known about using digital tools to improve the quality of such care. Based on the experiences from two grant-funded GMH studies in rural Nepal, we share implementation practices and lessons learned from using digital tools to improve the quality of care. We highlight several best practices and approaches in addition to the critical role of involving end-users in the design process. Our suggestions include starting with the lowest-barrier strategies and iterating the tools as the clinical team gains comfort. Additionally, we emphasize the importance of clearly defining the specific problem the digital tool is intended to address, and keeping the tool lean to only address that problem. Furthermore, we suggest paying attention to how technology had been used prior to the introduction of the new tool, as this context will impact the expectations and engagement of the end-users. Finally, we emphasize that digital tools are usually not an intervention but are effective at facilitating and enabling interventions such as providing supportive supervision to enhance quality of care. We include specific examples from our studies and draw generalizable lessons for the broader GMH researcher and practitioner community interested in improving not just access to but also the quality of mental health services by leveraging digital tools in low-resource settings.