Developing the West African Digital Mental Health Alliance (WADMA)

In the past decade, West Africa has had an increase in digital health technologies, which leverage its robust mobile cellular infrastructure to deliver care. There is increasing attention to utilizing mobile health (mHealth) for awareness, screening, diagnosis and treatment of mental illnesses¹. The landscape of mHealth in mental health is characterized by the use of digital innovations such as SMS messaging, smartphone applications and web-based resources to expand access to mental health care². Digital mental health tools, which are available through widely accessible technological platforms, hold promise for narrowing the global mental health care gap^2,3.

There is a shortage of trained mental health professionals and bricks-and-mortar mental health facilities in Africa. Recent digital mental health innovations developed and leveraged elsewhere show promise for addressing patient-, system- and policy-level challenges⁴. Training opportunities that engage regional interdisciplinary stakeholders can build capacity for local digital mental health research and development.

Our group developed the West African Digital Mental Health Alliance (WADMA) to help address these critical needs. WADMA is a mission-centered network that facilitates digital mental health research and cross-institutional collaboration between technologists and clinical researchers. The group originated as a collaborative effort between researchers and clinical experts at the University of Washington in the United States, the University of Ghana, the University of Ibadan and several other organizations based in West Africa. WADMA will foster a new generation of digital mental health researchers and practitioners committed to advancing mental health services using digital innovations in Africa.

Digital interventions show potential for diagnosing, treating and preventing mental health conditions in low- and middle-income countries (LMICs)⁵. Partnerships among mental health stakeholders in the African region have already given rise to collaborative digital innovations designed to address unmet mental health needs. Examples include the development of mobile phone applications such as M-Healer to train faith healers in evidence-based psychological methods in Ghana⁵, HealthAlert and MalariaConnect to augment the insufficient numbers of health workers in South Africa⁶, and an application to manage depression in low-income perinatal adolescent mothers in Nigeria^7,8. To achieve meaningful transformation in mental health research and service development in West Africa, there is an increasing need to strategically coordinate, harness and drive current and future digital innovations⁹. Forming an alliance of mental health stakeholders will streamline innovation, knowledge-sharing and research to advance mental health care in West Africa and beyond.

WADMA will serve as a meeting ground, convening mental health researchers and clinicians with technology developers, user-centered designers and digital innovators in West Africa to support the development of novel interventions to improve mental health in the region. Critics of digital mental health interventions in LMICs point to an imbalance between the number of high-income country researchers working in the digital intervention space and the number of local researchers focused in this area⁷. WADMA will attempt to shift this inequality by providing West African mental health researchers and clinicians with the resources and tools needed to lead digital mental health innovations for the populations they represent.

We envision strong interest in WADMA from psychiatrists, clinical psychologists and mental health nurses, as well as mental health researchers and practitioners, in West Africa. We also aim to attract computer scientists, technology developers and digital entrepreneurs in the region who are driven to apply their technical knowledge toward improving mental health outcomes. WADMA leaders recognize the importance of user-centered designers, graphic designers and artists in developing usable and culturally appropriate digital tools and interfaces. WADMA leaders will leverage global professional networks to garner members from these diverse fields. WADMA members also recognize the need to gain support from governmental leaders in health and technology to ensure the success, sustainability and future impact of WADMA endeavors. Notable stakeholders in ensuring the scalability of WADMA innovation will include governmental leaders and policymakers in West Africa, large corporate entities such as cellular network providers operating in Africa, and entrepreneurial and corporate technology product developers.

WADMA will foster a new generation of digital mental health researchers equipped with the skills required to develop, implement and scale up digital interventions that serve mental health needs of African populations. Digital mental health interventions created by WADMA members are co-designed with communities, evaluated for usability, acceptability and feasibility, and ultimately scaled and sustained via African-based public-private partnerships. WADMA leaders have demonstrated this process with digital mental health interventions for people living with serious mental illness in Ghana^5,10 and perinatal depression in Nigeria⁷.

WADMA will facilitate matchmaking between WADMA members to convene teams with promising combinations of skill-sets, experiences and interests for digital mental health intervention development. We will build capacity through training activities on a range of relevant topics (such as an introduction to digital mental health and user-centered design for digital mental health interventions), resource-sharing, peer mentorship and cross-disciplinary knowledge-transfer activities. WADMA leaders will instill grant acquisition and business development skills in new digital mental health innovators, ensuring the scalability and sustainability of WADMA-initiated digital mental health initiatives. WADMA will ensure that digital mental health innovation is developed in West Africa for Africans, and that intellectual property rights and profits remain in the region.

Multiple West African countries have taken strides in developing and creating mental health policies and expanding supportive legislation. WADMA will consult with policymakers and leverage governmental momentum toward expanding mental health access through technology.

African youth will constitute 42% of the world’s young people by 2030. This generation has grown up with exposure to digital technologies. Nigeria and Ghana are among the top innovators in Africa’s start-up scene – and young people are leading the charge. This ‘youth bulge’ offers a large talent pool from which future digital mental health intervention developers can emerge who understand the acceptability, reach and potential impact of digital tools for mental health.

African community ties are strong. In West Africa, traditional and faith healers are frequently visited for mental health problems. Village leaders take a prominent role in advising community members, and youth groups offer mentorship to at-risk young people. WADMA members are well positioned to consult these groups about the content, format and function of digital interventions, as well as their usability and acceptability. This positioning will help ensure that digital mental health interventions are deployed widely to populations in the region for optimal benefit.

WADMA will leverage regional readiness for digital mental health innovation by seizing opportunities and alleviating challenges for advancing mental health. WADMA will form sustainable collaborations that will make West Africa a leading region in digital mental health innovation. We intend for WADMA to serve as a global example of the impact that is possible through collaborative and purposeful partnerships.