November 2021

WITS University psychology researcher, Tasneem Hassem has been awarded R100 000 in seed funding to advance the development and commercialisation of the first validated online depression screening tool suitable to the South African context. Developed over four years as part of her PhD studies in psychology, the tool offers an empathetic and unintimidating first step towards recognising, understanding and seeking help for depression.

The innovation was chosen from eight in the final pitch of the latest Prospector@WITS course run by Wits Enterprise. Hassem and co-founder, WITS Professor Sumaya Laher, will be allocated an Innovation Support Manager from WITS Enterprise’s Innovation Support Unit to help take the tool to the commercialisation stage.

Hassem says the online screening tool answers to a need for greater awareness of depression in South Africa; helping people to identify their symptoms in the comfort of their homes and empowering them to start the treatment conversation without the stigma, and without waiting for a professional consultation to interpret screening results.

In South Africa, access to mental healthcare facilities is limited to around 4 beds per 100 000 population in general hospitals, and 16 beds per 100 000 in mental health hospitals[i]. 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[ii]. As a consequence of the limited or lack of mental healthcare resources in South Africa[iii], depression, often goes undiagnosed and untreated[iv]. Depression treatment is further compromised due to the social stigma attached to diagnosis and treatment, lack of awareness of symptoms, as well as the inaccuracy of depression screening tools[v]. During the past 18 months of the COVID-19 pandemic, the situation has been exacerbated as the effects of lockdown have impacted negatively on physical, financial and emotional wellbeing, increasing the incidence of depression. Access to health facilities has also been constrained by the lockdown.

Hassem, a registered research psychologist currently completing her PhD titled: “Adapting an online screening tool for Major depressive disorder in South Africa”, says that depression continues to increase in South Africa and globally.

“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.”

Hassem and Prof. Laher, who is the Head of the Department of Psychology at WITS and a Past President of the Psychological Society of South Africa, conducted a systematic review in 2019 of online depression screening tools for use in the South African context^[vi]. 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.

“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,” explains Hassem.

Hassem and Laher had to overcome some challenges in developing the tool.

“Adapting the tool was challenging as we had to consider various factors such as the ethical principles associated with online mental health screening, cultural appropriateness, content validity of the items as well as the fact that majority of potential tool 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,” says Hassem.

Commenting on the innovation, Anne Gabathuse, Senior Innovation Support Manager at WITS Enterprise: says: “Despite the challenges of research and development during the pandemic, these innovators demonstrated all the categories required for consideration in the Prospector@WITS course exceptionally well. They met with stakeholders and used the insights to shape the value proposition of the innovation, as well as optimise its appropriateness for the South African context. 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.”

Ela Romanowska, Director of Innovation Support at WITS Enterprise says “The Prospector@WITS course, now run three times per year, has helped identify many very promising products based on the world-class research conducted at WITS. What is exciting in this instance is that the tool developed by Ms Hassem and 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.”

Hassem and Laher are grateful to William Eaton and the team from the National Institute of Mental Health for enabling adaptations of the CESD-R tool by placing it in the public domain, as well as the National Research Foundation and Phillip Tobias Scholarship for providing much-needed research funding.

“I am also grateful for the opportunity to be part of the Prospector@WITS Course through which I have learnt so many new skills about the business environment that we as researchers tend to overlook when trying to roll out innovations. I hope that this tool will benefit the South African community and help raise awareness about mental healthcare and wellbeing,” concludes Tasneem.

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 the website.

Written by Wits Enterprise

[i] World Health Organisation [WHO], 2017

[ii] Docrat et al., 2019

[iii] Burns 2011; Lund et al., 2010; Matsea et al., 2018

[iv] Nglazi et al., 2016

[v] WHO, 2017

[vi] Hassem, T., & Laher, S. (2019). A systematic review of online depression screening tools for use in the South African context. South African Journal of Psychiatry, 25(1), 1-8.[vi]