{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T07:04:31Z","timestamp":1784617471612,"version":"3.55.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Mental health conditions are among the fastest growing and most inequitably distributed global disease burdens. Structural determinants- poverty, conflict, climate change, and the COVID-19 pandemic compound a persistent mismatch between internationally developed policy frameworks and the cultural and infrastructural realities of populations in the Global South.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This systematic review identified, appraised, and synthesized gray literature evidence on (1) the growing mental health burden across Global South regions (2015\u20132025); (2) digital technology responses in Global South LMIC contexts; and (3) policy, cultural, and community-based factors shaping mental health transformation efforts.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A pre-registered systematic gray literature review spanned five source tiers. Following systematic screening and AACODS quality appraisal, 140 records published between 2015 and 2025 were included.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Four themes emerged: (1) an accelerating, structurally driven mental health burden across Global South regions; (2) a severe and entrenched treatment gap sustained by chronic underinvestment, workforce shortages, and stigma; (3) a rapidly expanding but uneven digital mental health landscape, in which SMS-based and CHW-mediated platforms achieve substantially greater reach than smartphone-dependent tools; and (4) significant structural, cultural, and policy barriers constraining scale-up. The effectiveness of digital mental health interventions (DMHIs) varies by modality, population, and setting, and is not a single generalizable finding.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The mental health burden in the Global South is growing faster than existing systems can address. Transformative progress requires sustained investment in CHW-mediated digital tools, culturally co-designed platforms, decolonized research partnerships, and mental health policies that center Global South communities as co-producers of their own mental health futures.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1875110","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:40:17Z","timestamp":1784616017000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The growing burden of mental health and the role of digital technologies in the Global South: policies, cultural contexts, and community-based transformations\u2014a systematic review of gray literature evidence"],"prefix":"10.3389","volume":"14","author":[{"given":"Joseph Odhiambo","family":"Onyango","sequence":"first","affiliation":[{"name":"Centre for Social Behavior Change and Strategic Foresights, Strathmore Business School, Strathmore University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","unstructured":"Geneva\n WHO\n World mental health report: transforming mental health for all.\n \n 2022"},{"key":"B2","first-page":"329","article-title":"Global, regional, and national burden of mental disorders, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"11","author":"GBD","year":"2024","journal-title":"Lancet Psychiatry"},{"key":"B3","unstructured":"Geneva\n WEF\n The global economic burden of mental illness: mental health matters.\n \n 2022"},{"key":"B4","unstructured":"Washington, DC\n PAHO\n Mental health in the Americas: an overview of the mental health situation in the countries of the region.\n \n 2022"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1016\/S0140-6736(18)31612-X","article-title":"The Lancet Commission on global mental health and sustainable development","volume":"392","author":"Patel","year":"2018","journal-title":"Lancet."},{"key":"B6","unstructured":"Brazzaville\n WHO AFRO\n Mental health in the WHO African Region.\n \n 2022"},{"key":"B7","unstructured":"Washington, DC\n World Bank\n Out of the shadows: making mental health a global development priority.\n \n 2016"},{"key":"B8","article-title":"MHPSS","volume-title":"COVID-19 response: global monitoring report","author":"Inter-Agency","year":"2022"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1017\/S2045796024000672","article-title":"Prevalence of mental disorders in adult populations from the Global South following exposure to natural hazards","volume":"33","author":"Kip","year":"2024","journal-title":"Epidemiol Psychiatr Sci."},{"key":"B10","unstructured":"The State of the World's Children 2021: on my mind \u2014 promoting, protecting and caring for children's mental health\n \n 2021"},{"key":"B11","volume-title":"Comprehensive mental health action plan 2013\u20132030","year":"2021"},{"key":"B12","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s44192-025-00177-7","article-title":"A comprehensive review of mental health services across selected countries in sub-Saharan Africa","volume":"5","author":"Atewologun","year":"2025","journal-title":"Discov Ment Health."},{"key":"B13","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S2215-0366(15)00013-9","article-title":"The role of global traditional and complementary systems of medicine in the treatment of mental health disorders","volume":"2","author":"Gureje","year":"2015","journal-title":"Lancet Psychiatry."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1611988","article-title":"Reimagining digital mental health literacy from the Global South: a call for epistemic justice and innovation equity","author":"Joseph","year":"2025","journal-title":"Front Psychiatry."},{"key":"B15","unstructured":"London\n GSMA Intelligence\n The mobile economy Sub-Saharan Africa 2022\n \n 2022"},{"key":"B16","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/S2215-0366(17)30096-2","article-title":"Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review","volume":"4","author":"Naslund","year":"2017","journal-title":"Lancet Psychiatry."},{"key":"B17","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12889-023-17417-6","article-title":"The effectiveness of mental health interventions involving non-specialists and digital technology in low-and middle-income countries \u2014 a systematic review","volume":"24","author":"Wijekoon Mudiyanselage","year":"2024","journal-title":"BMC Public Health."},{"key":"B18","volume-title":"WHO guideline: recommendations on digital interventions for health system strengthening.","year":"2019"},{"key":"B19","volume-title":"Digital-in-health: unlocking the value for everyone.","year":"2023"},{"key":"B20","first-page":"1","article-title":"Digital mental health interventions for treating mental disorders in young people based in LMICs: a systematic review","volume":"11","author":"Wani","year":"2024","journal-title":"Camb Prisms Glob Ment Health."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e29307","DOI":"10.2196\/29307","article-title":"Gray literature in evaluating effectiveness in digital health and health and welfare technology: a source worth considering","volume":"10","author":"Stridsberg","year":"2022","journal-title":"JMIR Mhealth Uhealth."},{"key":"B22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1363461519898035","article-title":"Global mental health: interdisciplinary challenges for a field in motion","volume":"57","author":"Bemme","year":"2020","journal-title":"Transcult Psychiatry."},{"key":"B23","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/1471-2288-8-45","article-title":"Methods for the thematic synthesis of qualitative research in systematic reviews","volume":"8","author":"Thomas","year":"2008","journal-title":"BMC Med Res Methodol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.11124\/JBIES-20-00167","article-title":"Updated methodological guidance for the conduct of scoping reviews","volume":"18","author":"Peters","year":"2020","journal-title":"JBI Evid Synth."},{"key":"B25","unstructured":"Ottawa\n CADTH\n Grey matters: a practical tool for searching health-related grey literature.\n \n 2019"},{"key":"B26","unstructured":"Brazzaville\n WHO AFRO\n Making the case for investing in Mental Health in Africa.\n \n 2021"},{"key":"B27","unstructured":"New York\n UNICEF\n Global annual results report 2023: mental health.\n \n 2023"},{"key":"B28","first-page":"828010","article-title":"Burnout and post-traumatic stress disorder at the frontline of COVID-19: exploration of a mechanistic model","volume":"13","author":"Efstathiou","year":"2022","journal-title":"Front Psychiatry."},{"key":"B29","unstructured":"New Delhi\n NIMHANS\/MoH\n National Mental Health Survey of India 2022: key findings and state-level report.\n \n 2022"},{"key":"B30","unstructured":"Dhaka\n MoH&FW Bangladesh\n National mental health strategic plan 2020\u20132030: progress update 2022.\n \n 2022"},{"key":"B31","unstructured":"New Delhi\n SEARO\n Mental health in the South-East Asia Region: a situation analysis.\n \n 2022"},{"key":"B32","volume-title":"AI and task sharing for mental health: a field guide.","author":"Grand","year":"2023"},{"key":"B33","volume-title":"Mental Health Atlas 2020","year":"2021"},{"key":"B34","unstructured":"Geneva\n WHO\n Mental Health Atlas 2024\n \n 2024"},{"key":"B35","unstructured":"London\n United for Global Mental Health\n Financing of mental health: the current situation and ways forward.\n \n 2023"},{"key":"B36","unstructured":"Abuja\n Federal Ministry of Health\n National mental health policy for Nigeria 2022\n \n 2022"},{"key":"B37","volume-title":"mhGAP intervention guide for mental, neurological and substance use disorders in non-specialised health settings: version 2.0.","year":"2021"},{"key":"B38","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/S2215-0366(15)00013-9","article-title":"The role of traditional and complementary medicine in mental health","volume":"2","author":"Gureje","year":"2015","journal-title":"Lancet Psychiatry."},{"key":"B39","doi-asserted-by":"publisher","first-page":"e34901","DOI":"10.2196\/34901","article-title":"Motivations toward using digital health for mental health among university students in Bangladesh","volume":"10","author":"Sifat","year":"2022","journal-title":"JMIR Mhealth Uhealth."},{"key":"B40","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1177\/1043659605285411","article-title":"The role of the African traditional healer in women's health","volume":"17","author":"Nelms","year":"2006","journal-title":"J Transcult Nurs."},{"key":"B41","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/s44247-025-00231-y","article-title":"Developing a gender Framework for Responsive and Adaptive Design in Digital Health (FORWARD) from a review of reviews","volume":"3","author":"Kalbarczyk","year":"2025","journal-title":"BMC Digit Health."},{"key":"B42","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s11920-023-01426-8","article-title":"Global mental health: where we are and where we are going","volume":"25","author":"Moitra","year":"2023","journal-title":"Curr Psychiatry Rep."},{"key":"B43","doi-asserted-by":"crossref","first-page":"822299","DOI":"10.3389\/fpsyt.2021.822299","article-title":"The nine grand challenges in global mental health: implications for the field","volume":"12","author":"Bajbouj","year":"2022","journal-title":"Front Psychiatry."},{"key":"B44","unstructured":"World Bank Blog. Washington, DC\n World Bank\n Mental health conditions on the rise: countries must prioritize investments\n \n 2023"},{"key":"B45","volume-title":"All-in-ONE Telehealth platform: implementation report \u2014 Trinidad and Tobago Pilot.","year":"2023"},{"key":"B46","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/wps.21018","article-title":"The World Mental Health Report: transforming mental health for all","volume":"21","author":"Freeman","year":"2022","journal-title":"World Psychiatry."},{"key":"B47","unstructured":"New York\n UNICEF\n The state of the world's children 2021: on my mind.\n \n 2021"},{"key":"B48","unstructured":"London\n MHIN\n Digital mental health tools in humanitarian settings: a landscape review.\n \n 2023"},{"key":"B49","unstructured":"Nairobi\n Government of Kenya\n Kenya mental health action plan 2021\u20132025\n \n 2021"},{"key":"B50","unstructured":"Grand\n Challenges Canada\n \n \n Toronto\n Grand Challenges Canada\n Scaling mental health innovations in Sub-Saharan Africa: portfolio outcomes 2021.\n \n 2021"},{"key":"B51","unstructured":"United\n Nations\n \n \n Report of the UN secretary-general on mental health and COVID-19\n \n 2021"},{"key":"B52","unstructured":"Manila\n DOH Philippines\n Republic Act 11036 (Mental Health Act) implementation report: digital components 2023.\n \n 2023"},{"key":"B53","unstructured":"National mental health programme: community implementation status report 2022\n \n 2022"},{"key":"B54","unstructured":"Washington, DC\n PAHO\n Digital health strategy for the Americas 2021\u20132025\n \n 2021"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2024.71","article-title":"Digital mental health interventions for treating mental disorders in young people in LMICs","author":"Alagarajah","year":"2024","journal-title":"Camb Prisms Glob Ment Health."},{"key":"B56","unstructured":"London\n GSMA\n Mobile internet connectivity and mental health: evidence from LMICs.\n \n 2023"},{"key":"B57","unstructured":"London\n Wellcome Trust\n Global mental health research priorities: report of expert consultation.\n \n 2023"},{"key":"B58","unstructured":"Jakarta\n Kemenkes RI\n Digital mental health implementation: HOPE4Schizophrenia and Telepsychiatry Pilot Report.\n \n 2023"},{"key":"B59","unstructured":"Geneva\n ITU\/UNESCO\n The state of broadband 2022: accelerating broadband for new realities.\n \n 2022"},{"key":"B60","doi-asserted-by":"publisher","first-page":"e53","DOI":"10.1017\/S2045796022000373","article-title":"An outstanding message of hope: the WHO World Mental Health Report 2022","volume":"31","author":"Saraceno","year":"2022","journal-title":"Epidemiol Psychiatr Sci."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1875110\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:40:27Z","timestamp":1784616027000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1875110\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2026.1875110"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1875110","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"1875110"}}