Developing and Testing Tele-Support Psychotherapy through Mobile Phones for Youth (15–30 Years) with Depression in Uganda

In response to the rise in mental health problems among youth during the COVID-19 pandemic, we conducted a qualitative study in March 2022, using a user-centered design approach guided by ecological theories, to adapt group support psychotherapy into tele-support psychotherapy (TSP) via mobile phones. The development of a call platform, informed by the unified theory of acceptance and use of technology, was integrated into the Medical Concierge Group’s (TMCG) telehealth services under Rocket Health Africa. This platform included a dedicated toll-free line for psychotherapy, connecting users with lay counselors. An open-label randomized controlled trial (PACTR202201684613316) was conducted to assess the feasibility, acceptability, and effectiveness of TSP in combination with standard mental health services (n = 154) compared with standard mental health services alone (n = 146) among youth with mild to moderate major depression in Kampala. Participants commonly equated mental health with mental illness and reported significant challenges, including financial stress, substance abuse, and family dysfunction. Although digital interventions were largely accepted, some participants preferred in-person services. The adapted TSP maintained gender sensitivity and used folk tales, stories, riddles, and creative visualizations to facilitate emotional expression, acquisition of coping strategies, and income-generating skills, addressing both emotional and socio-economic needs.