Digital Health Applications in Mental Health Care for Immigrants and Refugees: A Rapid Review.

Objective: To explore and summarize (1) the existing digital health applications in mental health care (MHC) for immigrants and refugees and its outcomes; (2) how the ethical standards of digital health applications in MHC are implemented and reported; and (3) the challenges for scaling up digital health applications in MHC for immigrants and refugees. Methods: This review adopted a rapid review methodology. Available literature was searched in three online databases January 1, 2005, to February 28, 2019. Studies were included if they (1) applied digital health technologies, (2) focused on immigrants, refugees, or asylum seekers without age and country limitation, (3) reported nonclinical and/or clinical outcomes, and (4) were published in English or Indonesian. Narrative synthesis was developed based on the data extraction and quality assessment. Results: A total of 16 studies were reviewed that applied software, website, and videoconferencing technologies. These applications were applied in various stages of MHC (screening, assessment, diagnosis, and intervention). Participants reported satisfaction and positive attitudes toward applications of digital health in MHC, and positive improvement on their anxiety, depression, and post-traumatic stress disorder symptoms. However, the ethical standards of these digital health applications were poorly implemented and reported. Stigma toward mental disorders and lack of technology literacy were the main challenges in scaling up digital health applications for immigrants and refugees. Conclusion: Digital health applications in MHC are promising innovations that can improve the wellbeing of immigrants and refugees. As these technologies expand, ethical standards of practice and reporting need to be improved in delivering scalable digital MHC for immigrants and refugees.