A Process Narrative of Developing a Mobile App (Saksham) for Patients with Schizophrenia and Related Disorders in Low-Resource Settings

Abstract

Schizophrenia and related psychotic disorders cause significant disability and burden. Majority of these patients receive minimal psychosocial care. Globally, there has been explosive growth of telecom network with high internet penetration even in low-resource settings like India that has the second largest network in the world. Mobile apps for these patients have been designed in high-income countries. The studies from low and middle-income countries are lacking. Over this background, we aimed to develop a mobile app for patients with schizophrenia and related disorders for a funded project by an interdisciplinary team comprising of mental health professionals and computer science engineers. The plan was to conduct focused group discussions (FGDs) to assess needs and viewpoints of the stakeholders, followed by designing of text-based modules that would be digitally transformed into mobile-based application for use by the intended participants. Six key domains were identified in FGDs for intervention: medication adherence, activities of daily living, promoting physical health, engagement in meaningful work, building of social and support networks, and psychoeducation. We developed a mobile app (Saksham) for both patients with schizophrenia and their caregivers in English and Hindi. The development process was complex and passed through many phases. Saksham app was subsequently deployed in the research project. In this paper, we document the process of designing the mobile app with an aim to guide future developers and sensitize them about the inherent complexities in this endeavor.