ABSTRACT

mHealth Innovations for Nepali Adolescents & Potential Indirect Mental Health Costs

There is a growing trend to use mobile-based mental health interventions to combat high suicide and bullying rates in Nepal within adolescent populations, where 11.8% of the population is estimated to be between 13 and 17. While use of mobile technology is high among adolescent populations and offers a potential avenue for intervention, there is growing evidence of the negative mental health and wellbeing outcomes that can come from overuse/maladaptive uses of mobile/smartphones. Thus, this research aims to investigate the tension between mobile phone/smart phone usage as a true mHealth opportunity in Nepal or as a potential problem, introducing deleterious mental health effects of over-use of mobile phones/systems, based on the Theory of Basic Psychological Needs.

Using the urban-rural setting of the Lumbini Zone in Western Nepal (Province Five) researchers affiliated with the University of New Mexico’s (UNM) Nepal Study Center (NSC), conducted a focus group survey of 66 individuals from multiple stakeholder groups relevant to the research (adolescents, mothers, health professionals, and school administrators) in December 2018 in Rupandehi district as an exploratory assessment about the state of mental health knowledge/awareness, current cell phone practices/uses of mobile phones, and insight into those cultural/developmental burdens seen as most detrimental to the mental health of adolescents in the region. A second phase of this research has recently concluded, with close to 750 adolescents in grades 11 and 12 from seven different secondary schools surveyed on topics of emotional health, cell phone usage, life worries/troubles, cultural attitudes, and currently known health/treatment options.

Analysis will be undertaken to determine the direct and indirect effects of protective and adverse life factors on mental health outcomes, along with the mediating effect of cell phones on these relationships. Additionally, recommendations will be made as to the means and areas of focus that future mHealth initiatives aimed at Nepali adolescents should likely focus on, to have the greatest likelihood of success. Such policy recommendations may also lead to future research exploring the feasibility of such mobile-based (mHealth) interventions.

Research Team Investigators and Collaborative Team: The project team consisted of Dr. Alok K. Bohara – Professor, Department of Economics, UNM, and Siobhan K. Yilmaz – Ph. D. Candidate, Department of Economics, UNM. We acknowledge the help provided by our collaborator’s Lumbini Center for Sustainability (LCS) and their research & survey team (Ms. Swati Thapa, Mr. Dharma KC, Prakash Rayamajhi, Anup Poudel, Sharada Pathak and the PNMF & PNC college staff and several field supervisors, enumerators, & data coders). We also acknowledge the corporation of the schools which provided the interview sites and organized the participants: Shree Bhairav Navadeep HIgher Secondary School (Palpa), Shree Prithivi Higher Secondary School (Gulmi), Shree Sarvajanik Secondary School (Arghakhanchi), Shree Mahendra Bidya Secondary School (Arghakhanchi), Shree Saraswoti Secondary School (Arghakhanchi), Saibaba Higher Secondary School (Siddharthanagar), and Bhairahawa Namuna Higher Secondary School (Siddharthanagar).