Lay Summary

A qualitative research aimed to explore the feasibility of a WHO smartphone application for mental health for people in situation of unstable housing. This study suggests that, if adapted to their context and culture, the application, as a complement of the current available services, could help them to deal with stressful situations.

Background

Mobile health, as a form of e-Health, focuses on the development of smartphone applications to improve medical or mental health care. Some researchers have underlined the benefits of applications for mental health in Post Traumatic Syndrome Disease, anxiety, depression or stress. The importance of these applications has risen in the context of the COVID-19 pandemic. In France, the incidence of anxiety, depression, and psychological distress symptoms has increased since the beginning of the pandemic, with important social inequalities. Given the elevated levels of mental disorders commonly observed among refugees and asylum seekers, the provision and use of Mental Health and Psychosocial Support services is recommended. To better support people in psychological distress faced with barriers to accessing mental health care, the World Health Organisation has developed Doing What Matters in Times of stress (DWM). This intervention was designed to be broadly applicable to non-severe mental health issues and to be easily adaptable to different populations, cultures and languages. The main objective of this research is to explore the views of individuals in situation of unstable housing and the professionals who are in charge of them about the acceptability and feasibility of the intervention DWM in France.

Methods

A qualitative study was conducted with 48 participants. 22 of them were people in situation of unstable housing, 26 were professionals working closely with them at accommodation centres. 32 of them were interviewed individually using free lists to collect data about the use of technology for mental health purposes. 4 focus groups of 4 people each were conducted to explore the acceptability and feasibility of “Doing What Matters in times of stress”.

Results

DWM is perceived as an improvement by both professionals and people in unstable housing to access mental health care. However, concerns are raised on the cultural adaptations, vocabulary comprehension, translations, confidence relation, and interactions with trained helpers.

Conclusion

Evidence-based smartphone apps for mental health could approach these services to populations which are outside the radar of the healthcare system. However, even though mobile phones are used by people in unstable housing, there exists a digital divide. Further research has to be conducted with applications such as DWM (e.g, on a randomized trial) to test their acceptability and functionality.