hi everyone my name is Sarah in this
presentation I will talk about our
research on understanding challenges and
opportunities for digital mental health
support in Saudi
Arabia mental health disorders are
prevalent around the world yet they
remain stigmatized especially in the
Middle East mobile devices and apps are
increasingly adopted to facilitate
remote mental health counseling and
monitoring and support exibility to
mental health support in addition
mobile apps provide means of support
that mitigate stigma and deliver
self-help
tools while research on digital mental
health support is rapidly expanding in
the field of HCI the majority of past
research has focused on Western context
as technology becomes more prevalent
more efforts are needed to understand
technology used within the challenges
and opportunities of other countries and
cultures studies highlighted the
importance of considering culture in
designing Health interventions and
showed that it was associated with
increased intervention accessibility and
participant engagement and
outcomes in Arab populations cultural
and religious factors play a significant
role in the acceptance and Adoption of
digital Health interventions however
studies highlighted the under
representation of Arab and Muslim
populations in HCI
research in this study we focused on the
Kingdom of Saudi Arabia where rapid
digital
transformation of Health heare Services
is in progress and the influence of
religious and cultural factors could be
observed in the KSA mental health
disorders are considered a growing
problem where around 34% of Saudis have
experienced a mental disorder during
their life moreover mental health
conditions are highly prevalent in
recent generations of the Saudi
population anxiety and mood disorders
are the most common mental disorders
among the KSA population
especially among young Sai women in Sai
Society there is still a significant
stigma attached to mental health
disorders and mental health facilities
and cultural factors play a significant
role in shaping people's attitude to
toward seeking mental health care in
regard to Health digitalization in the
KSA there is a growing interest in
adopting digital Health tools the Sai
Ministry of Health has released various
M Health apps to support the Saudi 2030
of digital Health
transformation the adoption was
accelerated by the existing technical
infrastructure in the
KSA despite the high interest in Mobile
Health from the healthcare ecosystem and
stakeholders in the KSA there is a la of
research on the availability adoption
and acceptance of mobile apps in mental
health context in the
KSA in this study we aim to explore
these research questions what are the
main challenges and opportunities for
using mental health apps in the KSA from
the perspective of psychologist and
psychiatrist practicing in the
KSA what are available mental health
mobile apps in s ODI markets and what
are their characteristics and the type
of support they
offer to explore these questions we took
a mixed methods approach we conducted
sem structure expert interviews with
mental health clinicians to understand
the adoption of M Health in practice and
identify the main opportunities and
challenges to the use of technology in
the local mental health
context to better understand our
clinicians mental model of the current
state of Arabic mental health mobile
apps and further understand in detail
available apps and their characteristics
we conducted a systematic review and
content analysis of mental health mobile
apps available from the Saudi app
stores in our exploratory qualitative
study we interviewed a total of 12
psychiatrist and psychologists from
different areas and institutions
practicing in the KSA with time in
practice ranging from one year to more
than 10 years we then use thematic
analysis to analyze the collected
data we further systematically reviewed
publicly available Arabic mental health
and well-being mobile apps on the Saudi
Apple App Store and Google play in order
to form a basis for understanding what
KSA users have available and verify our
clinicians mental model of the state of
Arabic mental Health
apps through the systematic search
process shown on the flowchart our
exploratory review
identified Arabic apps that targeted
mental health and mental well-being and
supported the Arabic language we
downloaded them analyzed their content
and coded their features according to
existing M Health assessment Frameworks
namely
Mars here we highlight some of our key
findings from our thematic analysis we
identified five themes
the first one is current practices in
adopting technology in Saudi mental
health care where we found that despite
the high interest in digitalization in
the KSA tools for screening assessment
and treatment remain paper based in
practice and present privacy and stigma
related
challenges on the other hand there is a
growing support for virtual clinics as a
response to the covid-19
pandemic the second theme is clinicians
perception of publicly available mental
health mobile apps where we found High
awareness of available commercial apps
providing online psychological
consultations such as Le and half of our
participants reported providing their
services via existing commercial apps
except for online consultation apps most
clinicians reported a weak awareness of
available Arabic mobile apps supporting
their therapeutic practice with the
clients such as assessment tracking and
meditation
the third theme is perspectives around
technology facilitated privacy and
anonymity in remote consultation apps
clinicians discussed the advantage of
privacy facilitated by technology in
supporting seeking mental health help in
Saudi Society especially for those who
have fears of social stigma as they can
receive Mental Health Care privately at
home without anyone knowing about
it professionals also reported that most
of their clients s maintained a degree
of privacy by keeping their camera off
during online sessions and this behavior
is very common among women clients some
professionals perceived this Behavior as
a challenge to the effective examination
and building a Therapeutic Alliance with
clients so some professionals limited
their services to visual sessions only
on the other hand other professionals
prioritized the importance of supporting
service accessibility in the current
time over service quality to not adding
more obstacles by obligating clients to
turn on their camera for better Services
as they hardly reach those individuals
in need and adding more obstacles may
take them a step
back clinicians also discussed the
remarkable role of implementing
anonymity within commercial ABS in
supporting seeking psychological help
within Saudi Society professionals
mentioned that such Services helped a
lot of individuals to seek mental health
care as a lot of them have concerns
about visiting psychatric clinics they
also discussed the advantage of
anonymity for some Saudi individuals as
it helps them to talk freely about
highly stigmatized
problems professionals had different
perspectives regarding seeing Anonymous
clients some clinicians discussed the
possible adverse effect of anonymity on
the treatment process Therapeutic
Alliance and therefore they do not
accept to see anonymized clients on the
other hand some clinicians acknowledge
the challenges introduced by anonymity
but prior I responding to the current
Mental Health crisis by supporting C
accessibility at the current
time clinicians also argued about the
impact of anonymity on mitigating the
stigma associated with mental disorders
some professionals noticed that the
ability to be anonymous considerably
encouraged Saudi individuals to seek
help as such ABS helped to mitigate self
stigma however others expressed their
concerns about anonymity unintentionally
reinforcing the stigma around mental
illness in general
the fourth theme is concerns about
possible challenges exacerbated by
adopting technology in mental health
care some professionals expressed their
concerns as some clients on Online
private platforms see several
professionals during the same period
sometimes on the same day for the
treatment of the same problem without
any communication between these
Specialists clinicians discussed that
while this paper is seen in practice it
is easier to be noticed and controlled
in traditional clinics and harder for
clients to to continue doing it however
in technology it is only one click to
see another clinician especially in
online commercial platforms
professionals expressed that this
Behavior hinders Therapeutic Alliance
and client adherence to the treatment
plan resulting in poor
outcomes professionals also noticed that
clients on online platforms expect
immediate responses and instant services
including diagnosis and treatment
professionals further discussed some
points to support the adoption and
integration of mobile apps into the
Saudi Mental Health Care such as
empowering clients to control access to
their collected data and support sharing
them confidentially with their
clinicians in addition providing
cultural adaptation such as supporting
family involvement besides considering
individuals preferences and clinicians
expertise while designing mental health
mobile apps to maximize Effectiveness
and reduce potential harm to
clients regarding our up review results
we identifi over 100 apps existed in
Arabic most of these apps were
categorized under health and fitness
medical purposes and lifestyle they
targeted a number of goals such as
improving overall mental health
overcoming depression reducing anxiety
and relieving stress the analyzed apps
employed a number of theoretical
strategies as shown in the figure the
most commonly offered strategy was
information education followed by
relaxation feedback counseling and
meditation
apps during our analysis we found that
five apps of the reviewed apps were
certified by the S Ministry of Health
three of them offered mainly fee based
teal consultation such as La fam care
and
tinara they aim to tackle the stigma
around mental health issues in Saudi
Society by anonymously connecting
individuals looking for mental health
services with licensed Mental Health
Specialists the other two apps were kib
and Deli which were released by The
National Committee for mental health
promotion and mainly provided
educational contents along with free
psychological text
consultations based on our findings we
identified a gap between the Saudi
Vision 2030 that highlighted the
importance of digitalization across
healthc care sectors and the actual
practices while on one hand there was a
remarkable effort in implementing
virtual clinics and supporting telec
consultations surprisingly our findings
show that clinical procedures and
therapeutic tools remained paper based
such as assessment scales and CBT
worksheets similar to other Global
Studies most mental health professionals
in our study were not familiar with and
had no experience using Arabic mental
health apps in supporting care except
for the teleconsultation apps despite
that they expressed positive attitude
toward adopting them our results showed
that technology facilitated features
such as privacy and anonymity help
individuals in the KSA to overcome
several s related issues such as the
fear of public stigma the fear of
judgment or social consequences of
sharing highly stigmatized problems the
fear of damaging their family social
image when seeking mental health
treatment thus our results argued that
barriers to seeking mental health care
in the KSA could be less tied to
individuals willingness and more
connected to the medium used to
healthcare delivery demonstrated by the
high demand for mental health apps that
maintain a degree of privacy and anonity
over face- Toof face phys
from care providers perspectives however
maintaining anonymity and turning off
the camera we scen by our clins as
potentially harmful to building
therapetic alliance between clients and
providers and effective examination it's
worth noting that the T medicine
regulation in the KSA leaves up to
clinicians to offer counseling via the
channel they see fit given that further
guidance remain lacking there remaining
a potential conflict between clinicians
who prefer video consultations and
patients preferences for privacy
preserving and stigma avoiding channels
this Gap needs policymaker
attentions while the commercial App
Market has significantly facilitated
service exibility to the extent that one
click is enough to see a doctor
clinicians expressed their concerns
about the growing phenomenon of Doctor
shopping the adverse effect of this
growing Behavior remain complicated and
our participants viewed this as as a
potential obstacle to the Therapeutic
Alliance in summary in this paper we
sought to understand whether the social
and cultural context of the KSA
presented unique opportunities and
challenges for mental M health and
whether this app served the particular
need of the Saudi population through
interviews with clinicians in the KSA we
explored how religion stigma and social
Norm served as both barriers and
opportunities for technology to support
seeking mental health health
our app review further discovered the
availability of more than 100 Arabic
mental health abs and many of them were
locally developed we thank our
participants for their valuable insights
and thank you for your time and interest
in our paper