Preferences toward digital and non-digital mental health treatment delivery formats: A survey of Indian college students (Preprint)

BACKGROUND Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. OBJECTIVE To understand the attitudes of Indian college students toward a variety of digital and non-digital treatment delivery formats. METHODS Indian college students received descriptions of seven treatment delivery formats: unguided digital self-help, guided digital self-help, bibliotherapy, one-on-one therapy with a professional, one-on-one therapy with a lay provider, group therapy with a professional, and group therapy with a lay provider. They were asked to rate each delivery format on three domains: a) perceived helpfulness, b) availability, and c) willingness to try. RESULTS 95% of individuals were willing to try one-on-one therapy with a professional, 56% were willing to try one-on-one therapy with a lay counselor, participants were less willing to try group interventions than one-on-one interventions, and <50% were willing to try digital self-help interventions. Additionally, there was a strong association between willingness to try and ratings of helpfulness (r=0.61). Ratings were not associated with gender, age, or depressive symptoms. CONCLUSIONS Our findings suggest that one barrier limiting the uptake of digital interventions in LMICs is that individuals do not perceive them as helpful. Efforts to disseminate information about non-traditional intervention delivery formats and their benefits are warranted.