Mental Health Plus Colombia

Youth-friendly tool to detect and prevent mental health disorders in Colombia, at no cost to them and based on cutting-edge research techniques.

We aim to create an interactive platform guided by artificial intelligence that allows reaching the greatest number of young people between 10 and 24 years of age to detect and prevent possible mental disorders. For this, we will create a digital tool (Application and Webpage) based on the characteristics of young people in Colombia, which will consider the bio-psycho-social and cultural factors that can predispose them to mental illness, and thus implement preventive interventions to the problems of these young people. This tool will be developed by the hand of young people from the moment of its design to guarantee their commitment and participation in the prevention of mental health problems. As a result, a resource will be available to young people who have problems in accessing mental health services, either due to stigmatization, before which confidentiality and autonomy in the use of the tool will be guaranteed, or because the system costs prevent it, before which a tool is proposed at no cost for young people. By integrating cutting-edge techniques in the design, the tool is provided with a level of analysis capable of interacting with sensitivity and precision according to the needs of each person.

In Colombia, considering the national mental health survey in 2015, 4.7% of children between 7 and 11 years old have presented some mental disorder in the last year. Furthermore, 7.2% of adolescents between 12 and 17 years old and 10.1% of adults between 18 and 44 years old have some type of mental illness. Despite this, people in Colombia, especially those who live in rural areas, have some problems accessing or consulting mental health services, either due to the availability of services or the stigmatization that this can cause to them. The latter is particularly increased in adolescents, and, unfortunately, it is where the manifestation of mental health disorders usually begins. However, early detection of mental health problems can improve a person's level of functioning in adulthood. Given this, there is a need for sensitive and specific detection methods that allow supporting this population in a scalable way and at a low cost. The pandemic caused by COVID-19 brought with it an increase in mental health problems, however, it also produced an improvement in access to internet services, creating the opportunity to reach more people in remote and rural areas. The above raises the conditions for the development of a mental health solution hand in hand with cutting-edge technology to be scalable and sustainable. In this sense, we still have time to mitigate some of the effects of the pandemic on mental health and even to prevent the appearance of future problems.

Our innovation provides a free digital tool for young people, mainly for residents of rural areas or who do not have direct access to mental health services. Additionally, internet access in Colombia accelerated during the pandemic, allowing the proposed tool to reach more people throughout the country, even in remote places where primary health services are scarce. Of course, the tool will be able to work while offline, until there is a possibility for it to be connected and can be updated with the central control system. Besides that, by involving underserved young people with lived experiences in different mental health problems since the solution is designed, this will increase its acceptability and adoption in the desired communities. All the above will increase the capacity to detect and prevent mental health disorders in Colombian young people. The implementation of the solution will begin in the central savanna area, but its development will have the potential to reach new regions. In this sense, our tool allows us to reach underserved people who wish to monitor their mental health, either because they already have a problem or because they want to prevent it, providing them access to preventive interventions sensitive to their problems and their community. Finally, for those cases that require clinical management, the platform with the prior authorization of users will help them connect to other available support routes, either to receive virtual or face-to-face care from a professional.

The solution will involve underserved youth from design to implementation and evaluation of the tool. Specific needs will be collected through mixed research methodologies, always respecting their resources and those of their families to address mental health. This will allow the tool to be sensitive to the problems of young people, therefore it can be adopted easily in the community. On the other hand, the team has experience researching with young people from the community where the study intends to take place, which favors the engagement of the participants, thus, the fulfillment of the proposed objectives. We live in a rural area where the early adopters of our solution will be found, we know the sociodemographic characteristics of the community, with this in mind, we will seek to create the best solution hand in hand with them.

A technological solution to prevent mental health problems will be developed and explored in a sample of 150 participants from the community of the central savanna area in Colombia. At this time, we proposed a theoretical model that must be tested to see if it meets the needs of the youth of this community in terms of mental health; following all the procedures with statistical rigor, the levels of adjustments of the model, and its predictive relevance will be evaluated. Likewise, once the tool is built, the platform's revenue model will be tested and adjusted if necessary to ensure its sustainability. In this way, it will be verified whether the variables considered within the model are sensitive for the prediction and detection of mental health problems.

Our solution is based on the creation of a new technology guided by a machine learning model, which allows us to detect with sensitivity and precision the mental health problems of young people and carry out preventive interventions for them. The development will begin with the measurement of some variables that have already been shown to be of clinical relevance for the manifestation of various mental disorders. Then, in the design and construction of the interface that will interact with potential users, the young people with whom the latter data have been collected will be involved to guarantee its acceptability. Once it is ready, the tool will be tested with the same young people to measure its effectiveness for the detection and prevention of mental health problems. If successful, the solution will have enough empirical evidence to be scaled to other communities and why not to other countries. In other words, our innovation provides a free technological solution to young people capable of preventing mental health problems in a scalable and sustainable way. It is also important to note that preventive interventions have already been empirically validated and will be tested on our potential users.

Currently, we have not launched the solution because first, we are going to collect the data to develop a sensitive and specific tool for young people. In this sense, in the following year, we expect to serve 150 young people from the central savanna region of Colombia. With these, we will design, build and validate the technological tool to prevent mental health problems. Likewise, the youth and their families will benefit from the individualized feedback delivered after the assessment. This report will return detailed and clear information on the evaluated areas, including but not limited to the performance obtained in each of the tasks. After that, the trained model can be used in other young people in this region and readjusted according to the needs of other communities.

For the next year, we have three priority outcomes that we expect as an effect of implementing our solution and these are: increasing the well-being of young people, reducing the severity of their symptoms, and improving their functioning. The study will reach 150 young people between the ages of 10-24, who are the ones who will be part of the implementation and evaluation of the solution and on whom the priority outcomes are evaluated. In this sense, these young people will also benefit from the personalized feedback that will be issued once the proposed data collection is completed. With this, they and their families will be better informed of what mental health care entails and have access to a validated tool in the community. However, once it is ready, the tool will have the potential and the infrastructure to reach most young people in the community and can be taken to new regions. Thus, mental health problems can be prevented, anticipated, and understood at an early stage, which can improve the prognosis in the evolution of symptoms and signs in various diseases of this type. The above will contribute to a comprehensive and transformative understanding of the mental health of young people in Colombia.

At the end of the year, a first version of the interactive platform validated by the 150 participants from the central savanna region of Colombia will be ready. The adjustment levels of the artificial intelligence model that will guide the platform will be a quantitative measure that is sensitive to the mental health problems of young people in that region. Additionally, during the implementation of the strategy, there will be immediate and intermediate objectives that must be achieved to affirm the success of the solution. These objectives include a significant increase in the level of well-being measured with the WHO Five Well-being Index (WHO-5), a decrease in symptoms and a significant improvement in the level of functioning measured by the Clinical Global Impressions Severity (CGI-S), and the Psychiatric Impairment Rating Scale (PIRS). The scales will be applied in two moments (pre-post) to verify that the changes are produced by the interaction with the technological platform. When necessary, the modified scales for children and adolescents will be used, as well as the adaptations of the instruments to Spanish. Finally, the feedback of the young people and their families will be a constant criterion of evaluation, since it is a priority for this project to achieve the engagement of the young people and their acceptance. The above will be assessed through focus groups and the qualification of the strategy that implements the tool to address mental health.

Possible difficulties can be found in the construction of the tool, and it is concerning the statistical sensitivity of the variables chosen for the model, hence the relevance of building this solution hand in hand with the youth of the community. On the other hand, access to digital devices, although it improved with the pandemic, will be verified and managed if necessary so that young people can have access to the tool. To protect all legal aspects, consent will be obtained from all participants and their families if necessary. Likewise, the phases of the investigation, their implications, possible risks, and benefits will be sufficiently explained. A financial barrier may be the sustainability of the application once the grant ends, considering that it will be free for young people, for this reason, a robust and strategic income model will be proposed to guarantee access to more young people.

We and our organization are in a largely rural area where the early adopters of our solution will be found. The accumulated experience of the team will provide the necessary knowledge to address the complexity of mental health problems from a comprehensive perspective, always respecting the conceptions and existing resources in the community where the solution is to be implemented. I have experience as a data science specialist, which favors that with the information we collect in the first stage we can build the desired model to anticipate the mental disorders present in our community. The team also has experience facilitating activities for youth with lived experiences of mental health challenges. With all this in mind, my commitment and that of the team that I lead to create this youth-friendly service at a low cost and supported by the best available empirical evidence from our community will allow us to scale the solution to reach the largest number of young people. As a project leader, I am a person passionate about knowledge who seeks to take it to new contexts and put it at the service of others. My degree in psychology and currently my doctorate training in biosciences allow me to have the experience and knowledge required to develop first-rate research with methodological, analytical, and ethical rigor. The team that we create is made up mostly of young people with experience in different areas of psychology and with experiences lived in mental health challenges, who have innovative ideas and enough energy for us to collaboratively face the implementation of the project. In this way, we will generate a low-cost, sustainable, and scalable solution that can benefit young people in the area, but once validated and implemented, it will have the potential to reach other regions and even new countries.

Currently, we only work with the foundation team that we are part of and with whom we will support ourselves to infrastructurally and logistically be able to carry out the project, our name is:

• Centro de Investigación para el Avance de las Ciencias Sociales y de la Salud (name in Spanish)