Perceptions of the feasibility and acceptability of a remote counselling program for callers to a national mental health and substance use helpline, “If I missed your call, please call again; We don’t get checked upon by our families”: A qualitative study
1
Psychiatry, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
South Africa has disparities in mental health treatment access, and the COVID-19 pandemic further spotlighted a need for decentralized services. Since around 90% of South Africans have access to a phone, mobile technologies have the potential to transcend geographical and socio-economic barriers, and reduce inequities in service access. This could be achieved through evidence-based programs informed by service user and service provider perspectives. This study sought to explore key stakeholders’ experiences and perceptions of available mobile technology platforms.
METHODS:
This was an exploratory study with three participant groups: SADAG representatives; South African-based mental health and substance use experts; and SADAG service users. The stakeholders’ insights were explored through individual and focus group interviews, looking into acceptability and feasibility of remote mental health counselling programs in South Africa.
RESULTS:
We interviewed: 17 SADAG team members, 12 key experts and 19 service users. Participants found the concept of a remote mental health counselling program generally acceptable due to anonymity, convenience and the potential wider reach. However, some disadvantages were highlighted such as network issues and loadshedding, limited nonverbal cues, and lack of control over callers’ environment during sessions. To maximize the opportunities and minimize the potential barriers, participants recommended: (i) prioritizing underserved populations, (ii) content flexibility, (iii) strong systems for communication with service users and within SADAG, (iv) providing adequate counsellor training not only on content but also on handling high risk situations and (v) frequent supervision for counsellor well-being and boundary setting.
CONCLUSIONS:
Our findings highlight the potential of remotely delivered counselling programs to increase access to mental health services, and also provides insights into future remote models that are contextually appropriate. Furthermore, insights from this study, which included diverse stakeholder perspectives, have been used to inform the conceptualization and testing of a remote counselling program in collaboration with SADAG.
South Africa has disparities in mental health treatment access, and the COVID-19 pandemic further spotlighted a need for decentralized services. Since around 90% of South Africans have access to a phone, mobile technologies have the potential to transcend geographical and socio-economic barriers, and reduce inequities in service access. This could be achieved through evidence-based programs informed by service user and service provider perspectives. This study sought to explore key stakeholders’ experiences and perceptions of available mobile technology platforms.
METHODS:
This was an exploratory study with three participant groups: SADAG representatives; South African-based mental health and substance use experts; and SADAG service users. The stakeholders’ insights were explored through individual and focus group interviews, looking into acceptability and feasibility of remote mental health counselling programs in South Africa.
RESULTS:
We interviewed: 17 SADAG team members, 12 key experts and 19 service users. Participants found the concept of a remote mental health counselling program generally acceptable due to anonymity, convenience and the potential wider reach. However, some disadvantages were highlighted such as network issues and loadshedding, limited nonverbal cues, and lack of control over callers’ environment during sessions. To maximize the opportunities and minimize the potential barriers, participants recommended: (i) prioritizing underserved populations, (ii) content flexibility, (iii) strong systems for communication with service users and within SADAG, (iv) providing adequate counsellor training not only on content but also on handling high risk situations and (v) frequent supervision for counsellor well-being and boundary setting.
CONCLUSIONS:
Our findings highlight the potential of remotely delivered counselling programs to increase access to mental health services, and also provides insights into future remote models that are contextually appropriate. Furthermore, insights from this study, which included diverse stakeholder perspectives, have been used to inform the conceptualization and testing of a remote counselling program in collaboration with SADAG.
| eISSN: | 2654-1459 |
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