Mobilizing digital technology to implement a population-based psychological support response during the COVID-19 pandemic in Lima, Peru

Janeth Santa-Cruz; Leydi Moran; Marco Tovar; Jesus Peinado; Yuri Cutipe; Lourdes Ramos; Aldo Astupillo; Melanie Rosler; Giuseppe Raviola; Leonid Lecca; Stephanie L Smith; Carmen Contreras

doi:10.1017/gmh.2022.36

Mobilizing digital technology to implement a population-based psychological support response during the COVID-19 pandemic in Lima, Peru

Glob Ment Health (Camb). 2022 Jul 28:9:355-365. doi: 10.1017/gmh.2022.36. eCollection 2022.

Authors

Janeth Santa-Cruz¹, Leydi Moran¹, Marco Tovar^{1

2}, Jesus Peinado¹, Yuri Cutipe³, Lourdes Ramos¹, Aldo Astupillo¹, Melanie Rosler⁴, Giuseppe Raviola^{5

6

7}, Leonid Lecca^{1

5

6}, Stephanie L Smith^{5

8}, Carmen Contreras^{1

9}

Affiliations

¹ Socios En Salud, Lima, Peru.
² Faculty of Science and Health, School of Medicine, Peruvian University of Applied Sciences-UPC, Lima, Peru.
³ Ministry of Health, Lima, Peru.
⁴ University of Southern Florida, Tampa, FL, USA.
⁵ Partners In Health, Boston, MA, USA.
⁶ Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA.
⁷ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
⁸ Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
⁹ Harvard Global Health Institute, Harvard University, Cambridge, MA, USA.

Abstract

Background: The COVID-19 pandemic caused considerable burden on mental health worldwide. To address this emergency in Peru, Socios en Salud (SES) implemented an innovative digital system for the diagnosis and psychological therapy in vulnerable populations. We describe the development, implementation, and participant outcomes of this intervention.

Methods: We conducted an intervention in a general population of Lima, Peru using a digital tool, ChatBot-Juntos, incorporating the abbreviated Self-Reporting Questionnaire (SRQ) to screen psychological distress. Participants positive for psychological distress received remote Psychological First Aid (PFA) and grief therapy if needed. Participants with a mental health condition or safety concern were referred to mental health services. SRQ scores were collected 3 months after PFA sessions. Differences between screening and follow-up scores were compared using Wilcoxon sign-rank test.

Results: In total, 2027 people were screened; 1581 (77.9%) screened positive for psychological distress. Nine hundred ninety-seven (63%) people with psychological distress received PFA, and 320 (32.1%) of those were also referred for mental health care. At 3 months after follow-up, SRQ scores were collected for 579 (58%) participants. Significant reduction in SRQ scores was observed 3 months after PFA [median SRQ score changed from 9 to 5 (p < 0.001)], and after PFA plus referral to mental health services [median SRQ score changed from 11 to 6 (p < 0.001)].

Conclusion: Digital technology can be used to screen for psychological distress and deliver mental health support for populations affected by the COVID-19 pandemic. More research is needed to determine whether technology contributes to improved mental health outcomes.

Keywords: COVID-19; Peru; Psychological First Aid; digital chatbot; mental health.