Effectiveness of Digital Mental Health Intervention in Middle Eastern Conflict Zones

(A Technology-Based Meta-analysis)

Authors

  • Nurzahara Sihombing SD Negeri 107396 Paluh Merbau
  • M. Agung Rahmadi Sekolah Tinggi Ilmu Kesehatan Sehati Medan
  • Sarah Atikah Universitas Islam Negeri Sumatera Utara
  • Nanda Liana Lubis Universitas Islam Negeri Sumatera Utara
  • Lisa Maharani Rizki Universitas Islam Negeri Sumatera Utara
  • Helsa Nasution Universitas Alwasliyah Medan
  • Luthfiah Mawar Sekolah Tinggi Ilmu Kesehatan Sehati Medan
  • Rasil Hakim Hasibuan Universitas Islam Negeri Sumatera Utara

DOI:

https://doi.org/10.59680/medika.v4i1.2180

Keywords:

Anxiety, Conflict Zones, Depression, Digital Mental Health, Middle East

Abstract

This meta-analysis evaluates the effectiveness of digital mental health interventions in post-conflict regions of the Middle East by synthesizing findings from 47 studies (N = 8,427) published between 2015 and 2024. Using a random-effects model, the results demonstrate that digital interventions consistently produce significant reductions in symptoms of PTSD (g = 0.82, 95% CI [0.74, 0.90], p < .001), depression (g = 0.76, 95% CI [0.68, 0.84], p < .001), and anxiety (g = 0.71, 95% CI [0.63, 0.79], p < .001). Moderator analyses show that mobile application–based interventions (g = 0.88) outperform web-based platforms (g = 0.69). The optimal duration falls within the 8 to 12 week range (g = 0.85) with a retention rate of 76.4 percent. These findings confirm Maalouf et al.'s (2019) argument about the accessibility of digital technologies in conflict settings, yet indicate stronger effects for mobile interventions than those reported by Kamali et al. (2020). In contrast to the meta-analysis by Al Dweik et al. (2024), which examined general interventions, this study identifies the specific effectiveness of artificial intelligence–driven personalized treatment (g = 0.91) and encrypted peer-to-peer support (g = 0.87). The results reinforce that digital interventions can serve as a strategic alternative when conventional mental health services are difficult to access.

References

Ahmed, S. K., Hussein, S., Chandran, D., Islam, M. R., & Dhama, K. (2023). The role of digital health in revolutionizing healthcare delivery and improving health outcomes in conflict zones. Digital Health, 9, 20552076231218158. https://doi.org/10.1177/20552076231218158

Al Dweik, R., Ajaj, R., Kotb, R., Halabi, D. E., Sadier, N. S., Sarsour, H., & Elhadi, Y. A. M. (2024). Opportunities and challenges in leveraging digital technology to strengthen the mental health system: a systematic review to inform interventions in the United Arab Emirates. BMC Public Health, 24(1), 2592. https://doi.org/10.1186/s12889-024-19980-y

Baumel, A., Muench, F., Edan, S., & Kane, J. M. (2019). Objective user engagement with mental health apps: systematic search and panel-based usage analysis. Journal of Medical Internet Research, 21(9), e14567. https://doi.org/10.2196/14567

Ben-Zeev, D., Fathy, C., Jonathan, G., Abuharb, B., Brian, R. M., Kesbeh, L., & Abdelkader, S. (2017). mHealth for mental health in the Middle East: Need, technology use, and readiness among Palestinians in the West Bank. Asian Journal of Psychiatry, 27, 1–4. https://doi.org/10.1016/j.ajp.2017.02.010

Bertl, M., Metsallik, J., & Ross, P. (2022). A systematic literature review of AI-based digital decision support systems for post-traumatic stress disorder. Frontiers in Psychiatry, 13, 923613. https://doi.org/10.3389/fpsyt.2022.923613

Brotherdale, R., Berry, K., Branitsky, A., & Bucci, S. (2024). Co-producing digital mental health interventions: a systematic review. Digital Health, 10, 20552076241239172. https://doi.org/10.1177/20552076241239172

Burchert, S., Alkneme, M. S., Bird, M., Carswell, K., Cuijpers, P., Hansen, P., ... & Knaevelsrud, C. (2019). User-centered app adaptation of a low-intensity e-mental health intervention for Syrian refugees. Frontiers in Psychiatry, 9, 663. https://doi.org/10.3389/fpsyt.2018.00663

Casu, M., Triscari, S., Battiato, S., Guarnera, L., & Caponnetto, P. (2024). AI chatbots for mental health: a scoping review of effectiveness, feasibility, and applications. Applied Sciences, 14(13), 5889. https://doi.org/10.3390/app14135889

Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. (2019). New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. The Lancet, 394(10194), 240–248. https://doi.org/10.1016/S0140-6736(19)30934-1

Dehbozorgi, R., Zangeneh, S., Khooshab, E., Nia, D. H., Hanif, H. R., Samian, P., ... & Lohrasebi, F. (2025). The application of artificial intelligence in the field of mental health: a systematic review. BMC Psychiatry, 25(1), 132. https://doi.org/10.1186/s12888-025-06483-2

Fortuna, K. L., Naslund, J. A., LaCroix, J. M., Bianco, C. L., Brooks, J. M., Zisman-Ilani, Y., ... & Deegan, P. (2020). Digital peer support mental health interventions for people with a lived experience of a serious mental illness: systematic review. JMIR Mental Health, 7(4), e16460. https://doi.org/10.2196/16460

Frankova, I., & Sijbrandij, M. (2025). Preventing common mental health problems in war-affected populations: the role of digital interventions. Frontiers in Digital Health, 7, 1586030. https://doi.org/10.3389/fdgth.2025.1586030

Gan, D. Z., McGillivray, L., Han, J., Christensen, H., & Torok, M. (2021). Effect of engagement with digital interventions on mental health outcomes: a systematic review and meta-analysis. Frontiers in Digital Health, 3, 764079. https://doi.org/10.3389/fdgth.2021.764079

Gual-Montolio, P., Jaén, I., Martínez-Borba, V., Castilla, D., & Suso-Ribera, C. (2022). Using artificial intelligence to enhance ongoing psychological interventions for emotional problems in real or close to real-time: a systematic review. International Journal of Environmental Research and Public Health, 19(13), 7737. https://doi.org/10.3390/ijerph19137737

Hashemi, B., Ali, S., Awaad, R., Soudi, L., Housel, L., & Sosebee, S. J. (2017). Facilitating mental health screening of war-torn populations using mobile applications. Social Psychiatry and Psychiatric Epidemiology, 52(1), 27–33. https://doi.org/10.1007/s00127-016-1303-7

Ibragimov, K., Palma, M., Keane, G., Ousley, J., Crowe, M., Carreno, C., ... & Llosa, A. (2021). Digital mental health care in humanitarian & crisis settings: A mixed-methods exploration during the COVID-19 pandemic. https://doi.org/10.21203/rs.3.rs-779128/v1

Isa, A. K. (2024). Exploring digital therapeutics for mental health: AI-driven innovations in personalized treatment approaches. World Journal of Advanced Research and Reviews, 24(3), 10–30574. https://doi.org/10.30574/wjarr.2024.24.3.3997

Kamali, M., Munyuzangabo, M., Siddiqui, F. J., Gaffey, M. F., Meteke, S., Als, D., ... & Bhutta, Z. A. (2020). Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review. BMJ Global Health, 5(3). https://doi.org/10.1136/bmjgh-2019-002014

Karimzadeh, D., & Saeedi, A. (2024). AI for Mental Health Assessment and Intervention: A Systematic Review. International Journal of Modern Achievement in Science, Engineering and Technology, 2(1), 96–104. https://doi.org/10.63053/ijset.65

Luxton, D. D. (Ed.). (2015). Artificial intelligence in behavioral and mental health care. https://doi.org/10.1016/B978-0-12-420248-1.00001-5

Maalouf, F. T., Alamiri, B., Atweh, S., Becker, A. E., Cheour, M., Darwish, H., ... & Akl, E. A. (2019). Mental health research in the Arab region: challenges and call for action. The Lancet Psychiatry, 6(11), 961–966. https://doi.org/10.1016/S2215-0366(19)30124-5

Mesmar, S., Talhouk, R., Akik, C., Olivier, P., Elhajj, I. H., Elbassuoni, S., ... & Ghattas, H. (2016). The impact of digital technology on the health of populations affected by humanitarian crises: Recent innovations and current gaps. Journal of Public Health Policy, 37(Suppl 2), 167–200. https://doi.org/10.1057/s41271-016-0040-1

Mirzai, F., Nasiri, Z., Naeim, M., Imannezhad, S., & Javedani, M. (2024). Advancing mental health in the Middle East: a paradigm shift. Asian Journal of Psychiatry, 101, 104220. https://doi.org/10.1016/j.ajp.2024.104220

Murray, L. K., Tol, W., Jordans, M., Sabir, G., Amin, A. M., Bolton, P., ... & Thornicroft, G. (2014). Dissemination and implementation of evidence-based mental health interventions in post-conflict, low-resource settings. Intervention Journal of Mental Health and Psychosocial Support in Conflict Affected Areas, 12(4), 94–112. https://doi.org/10.1097/WTF.0000000000000070

Musa, M. (2024). Mental Health in the Middle East: historical perspectives, current challenges, and future implications. Saudi J Humanit Soc Sci, 9(5), 138–48. https://doi.org/10.36348/sjhss.2024.v09i05.001

Ng, M. M., Firth, J., Minen, M., & Torous, J. (2019). User engagement in mental health apps: a review of measurement, reporting, and validity. Psychiatric Services, 70(7), 538–544. https://doi.org/10.1176/appi.ps.201800519

Our World in Data (Roser, M.; Ritchie, H.; Dadonaite, B.). (2024). Psychiatrists working in the mental health sector (per 100,000 people) — dataset and visualization (synthesised from WHO Mental Health Atlas). Our World in Data. https://ourworldindata.org/grapher/psychiatrists-working-in-the-mental-health-sector

Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022). Digital health interventions for delivery of mental health care: systematic and comprehensive meta-review. JMIR Mental Health, 9(5), e35159. https://doi.org/10.2196/35159

Pinto, J. V., Hunt, C., & O'Toole, B. (2022). Advancing posttraumatic stress disorder diagnosis and the treatment of trauma in humanitarian emergencies via Mobile health: protocol for a proof-of-concept nonrandomized controlled trial. JMIR Research Protocols, 11(6), e38223. https://doi.org/10.2196/38223

Rajkumar, E., Lipsa, J. M., Harshit, S., & Gopi, A. (2025). Effectiveness of psychological interventions for mental health problems among war refugees: A systematic review and meta-analysis. Psychiatry Research, 116432. https://doi.org/10.1016/j.psychres.2025.116432

Rodríguez-Rivas, M. E., Cangas, A. J., Cariola, L. A., Varela, J. J., & Valdebenito, S. (2022). Innovative technology-based interventions to reduce stigma toward people with mental illness: systematic review and meta-analysis. JMIR Serious Games, 10(2), e35099. https://doi.org/10.2196/35099

Ruzek, J. I., & Yeager, C. M. (2017). Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities. Global Mental Health, 4, e16. https://doi.org/10.1017/gmh.2017.11

Ruzek, J. I., Kuhn, E., Jaworski, B. K., Owen, J. E., & Ramsey, K. M. (2016). Mobile mental health interventions following war and disaster. Mhealth, 2, 37. https://doi.org/10.21037/mhealth.2016.08.06

Segal, H., Benis, A., Saar, S., Shachar-Lavie, I., & Fennig, S. (2024). Digital Platform for Pediatric Mental Health Support During Armed Conflicts: Development and Usability Study. JMIR Formative Research, 8, e63777. https://doi.org/10.2196/63777

Shah, T. M., & Shah, J. M. (2024). AI's Role in Enhancing Humanitarian Efforts for Children in Armed Conflict. In Children and Youth as 'Sites of Resistance' in Armed Conflict (pp. 145–155). Emerald Publishing Limited. https://doi.org/10.1108/S1537-466120240000034009

Sim, K. Y. H., & Choo, K. T. W. (2025). Envisioning an AI-Enhanced Mental Health Ecosystem. arXiv preprint arXiv:2503.14883.

Simblett, S., Birch, J., Matcham, F., Yaguez, L., & Morris, R. (2017). A systematic review and meta-analysis of e-mental health interventions to treat symptoms of posttraumatic stress. JMIR Mental Health, 4(2), e5558. https://doi.org/10.2196/mental.5558

Tarafdar, R. (2025). AI-Supported Emotional Conflict Resolution: Technical Approaches and Implementation Strategies. IJSAT-International Journal on Science and Technology, 16(1). https://doi.org/10.71097/IJSAT.v16.i1.2792

Wang, K., Varma, D. S., & Prosperi, M. (2018). A systematic review of the effectiveness of mobile apps for monitoring and management of mental health symptoms or disorders. Journal of Psychiatric Research, 107, 73–78. https://doi.org/10.1016/j.jpsychires.2018.10.006

World Health Organization. (2021). Mental Health Atlas 2020. Geneva: WHO. https://www.who.int/publications/i/item/9789240036703

World Health Organization. (2024). Mental health in emergencies (WHO fact sheet/summary of WHO activities in emergencies). https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies

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Published

2026-01-29

How to Cite

Nurzahara Sihombing, M. Agung Rahmadi, Sarah Atikah, Nanda Liana Lubis, Lisa Maharani Rizki, Helsa Nasution, … Rasil Hakim Hasibuan. (2026). Effectiveness of Digital Mental Health Intervention in Middle Eastern Conflict Zones: (A Technology-Based Meta-analysis). Jurnal Medika Nusantara, 4(1), 23–41. https://doi.org/10.59680/medika.v4i1.2180

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