“In SA, access to mental healthcare facilities is limited to around four beds per 100,000 population in general hospitals, and 16 beds per 100,000 in mental health hospitals,” read the statement. “Access to mental healthcare practitioners is also limited. In 2019, the public sector reported having only 0.97 psychologists and 0.31 psychiatrists per 100,000 population,” the statement read.
As a consequence, the statement said, depression often goes undiagnosed and untreated in SA and treatment is further compromised by social stigma attached to diagnosis and treatment, lack of awareness of symptoms, and the inaccuracy of depression screening tools.
“During the past 18 months of the Covid-19 pandemic, the situation has been worsened as the effects of lockdown have affected physical, financial and emotional wellbeing, increasing the incidence of depression,” said the statement.
The lockdown also hampered public access to health facilities.
Hassem, who is completing her PhD titled “Adapting an online screening tool for major depressive disorder in SA” says, “Unfortunately, low awareness of the symptoms of depression means that many people do not know when they are depressed. During our research and through interviews with stakeholders, we determined that an online screening tool would help raise awareness of depression, reduce the stigma and facilitate quality conversations between people and health professionals,” she said.
Hassem and Laher, who is the head of the department of psychology at the university and a past president of the Psychological Society of SA, conducted a systematic review in 2019 of online depression screening tools for use in the South African context.
“The results indicated that, until now, there has been no depression screening tool specifically developed or adapted for the South African context. The research duo chose to adapt the Centre for Epidemiological Studies Depression Scale (CESD-R) to align it with the South African context,” the university said.
Hassem added, “Our tool is specifically adapted to capture the unique depression symptoms experienced by South African individuals. The user receives instant, downloadable feedback that provides resources for seeking treatment or care and can be used in the comfort of one’s home, on any smartphone, tablet, laptop or computer.”
Hassem said adapting the tool was challenging as they had to consider ethical principles associated with online mental health screening, cultural appropriateness and the fact that the majority of the tool’s potential users are not first-language English speakers.
“Piloting the tool on a representative South African sample was a key challenge as the pilot study was conducted during the Covid-19 pandemic while hospital access was restricted. We had to rely on healthcare professionals to circulate information of the study to potential participants,” said Hassem.
Anne Gabathuse, senior innovation support manager at Wits Enterprise, said Laher and Hassem fulfilled the categories required for consideration for the funding despite the challenges posed by the pandemic.
“We look forward to seeing the online tool in the market where it has potential to positively influence the lives of people with depression by improving understanding and facilitating conversations that empower them to seek help,” she said.
Wits Enterprise director of innovation support Ela Romanowska said the Prospector@WITS course now runs three times per year and has helped identify promising products based on research being conducted at Wits.
“What is exciting in this instance is that the tool developed by Ms Hassem and Prof Laher has significant potential to support our communities in an illness that is prevalent, yet difficult to diagnose and treat not least of which because of the unfortunate stigma associated with it. Innovation must meet the real needs of our citizens, and is not just about profits,” she said.
The next steps for the team entail piloting the online depression screening tool on a larger and more representative sample, and further developing and refining of the website.