STORIES & INSIGHTS

Digital lifelines for communities in crisis

Reimagining mental health and psychosocial support for forcibly displaced people in Sudan and beyond.

By Rowan Elmustafa, University of Edinburgh student-researcher
Digital MHPSS can help bridge gaps in traditional support systems. Image: shutterstock stock image edited by @kiunga_isaac
Digital MHPSS can help bridge gaps in traditional support systems. Image: shutterstock stock image edited by @kiunga_isaac

NB: The UNHCR Innovation Service hosts Edinburgh student-researchers exploring issues at the intersection of innovation and forced displacement. The opinions reflected in their research do not reflect the position of UNHCR.

More than 12.3 million people have been forcibly displaced from their homes in Sudan since April 2023. The trauma of displacement, compounded by an uncertain future and daily stressors, weighs heavily on their well-being. Mental health is often overlooked in an environment where even basic physical needs are difficult to meet. For many, access to mental health and psychosocial support (MHPSS) is as distant as the homes they left behind. Could technology offer a lifeline?

In the face of unprecedented displacement in the East and Horn of Africa and the Great Lakes (EHAGL) region, there is a growing turn to technology to support the provision of MHPSS. Sudan’s experience demonstrates both the challenges of digital MHPSS delivery and the extraordinary resilience of communities when equipped with appropriate tools.

To understand these dynamics, and what learnings they might elucidate for Sudan and other contexts, I recently conducted research with the support of the Innovation Service of UNHCR, the UN Refugee Agency. My findings indicate that, while digital MHPSS is no panacea, it offers vital opportunities to bridge gaps in traditional support systems, highlighting the need for nuanced, context-specific solutions.

 

What is digital MHPSS?

I use the term “digital MHPSS” to refer to the use of information and communication technologies to support the delivery of MHPSS services. It refers to the ways technology can help meet people’s mental health needs and facilitate access to resources, whether through phone hotlines, SMS services, mobile or web-based applications, internet platforms or other technologies that connect people to care.

 

Understanding Sudan’s experience of digital MHPSS

I set out to explore how digital tools and technologies support the delivery of MHPSS interventions for forcibly displaced people in EHAGL. Understanding this isn’t just about assessing whether technology works; it’s about digging deeper into human stories, systemic barriers, and opportunities for innovation.

The study examined the extent to which digital solutions are meeting the mental health needs of people forced to flee and explored how these tools are being used in real-world, crisis-affected settings. Sudan’s story became central to this inquiry: What do its unique practices reveal about implementing digital interventions in such a challenging environment? What cultural, systemic, and technological barriers stand in the way of scaling these tools? How do structural inequalities and competing priorities influence the design and delivery of MHPSS interventions?

To answer these questions, I used a mixed-methods approach, combining data and voices from multiple perspectives:

  • Mapping the landscape: A systematic review of existing digital MHPSS interventions and tools in Sudan.
  • Interviews: Semi-structured interviews with experts, frontline responders, and humanitarian actors to capture real-world challenges and opportunities.
  • Contextual analysis: Analysing humanitarian reports and needs assessments to frame digital tools within Sudan’s complex socio-political and infrastructural realities.

The study not only explores what’s working (and what isn’t) in Sudan; it also highlights how these lessons can be applied to digital MHPSS across the EHAGL region.

 

Bridging digital gaps: Tailored and hybrid models

Digital MHPSS is not a one-size-fits-all solution. The study revealed that the digital ecosystems across Sudan and the EHAGL region, despite similarities, are as diverse as the crises they address. Sudan, grappling with conflict, economic instability, and infrastructural decay, exemplifies the challenges of applying digital tools in resource-constrained settings. Mobile penetration is high, but internet access remains limited in rural and conflict-affected areas. By contrast, some countries, like Kenya and Djibouti, boast higher internet penetration and higher digital literacy rates, while South Sudan struggles with minimal connectivity. Even within countries, there are notable differences. For instance, rural areas tend to have less mobile penetration, network coverage, and digital literacy than urban settings.

These disparities necessitate hybrid models that combine high-tech and low-tech solutions. In Sudan, helplines, Interactive Voice Response (IVR) calls, and low bandwidth messaging platforms are critical for reaching service providers and forcibly displaced people who lack reliable internet access. Meanwhile, telemedicine platforms in Uganda and Kenya demonstrate the potential of high-tech interventions in regions with stronger infrastructure.

Hybrid approaches can cater to varying levels of digital readiness and literacy, ensuring inclusivity while leveraging technology’s full potential. Low-tech solutions like SMS services and IVR calls accommodate those with limited digital skills or access, while high-tech platforms such as smartphone apps and video conferencing serve users with greater digital proficiency. This multi-tiered approach allows for gradual skill-building, as users can progress from simpler to more complex digital tools as their capabilities grow.

Hybrid models also help in addressing urgent MHPSS needs while building infrastructure, skills, and systems for sustainable support. For instance, immediate crisis support can be provided through widely accessible channels like phone hotlines, while simultaneously investing in digital literacy programmes and infrastructure development for long-term resilience. This dual approach ensures that critical mental health services are available now, while also laying the groundwork for more sophisticated digital interventions in the future.

Understanding these contextual differences and tailoring solutions to underlying cultural and infrastructural factors is key to designing scalable, adaptable interventions, which ensure that services reach even the most marginalized people and resonate with the communities they aim to serve.

 

Promising examples from Sudan

Like many countries across EHAGL, Sudan faces significant challenges relating to limited digital infrastructure, low digital literacy, data privacy and security concerns, and cultural stigma surrounding mental health issues. Despite these obstacles, NGOs and grassroots initiatives currently being implemented are advancing mental well-being through, for instance:

  • Community-managed Facebook pages and WhatsApp groups: Peer-to-peer psychological first-aid groups thrive on platforms like Facebook and WhatsApp. These digital spaces offer connection and solace, bypassing traditional stigma around mental health. They also provide a discreet platform for counselling and support, safeguarding privacy while fostering empowerment.
  • IVR training for health responders: In regions with limited connectivity, some organizations have employed IVR tools to train medical professionals and community responders on delivering MHPSS. These interventions ensure that even the remotest communities have access to basic MHPSS.
  • Telegram channels for scalable training: For instance, the Sustainable Development Response Organization (SUDRO) used Telegram for their Sudan ECHO Centre of Excellence project to train more than 60,000 health care professionals, medical students and community-level responders on emergency medical response, including psychological first aid and trauma mental health. Leveraging Telegram’s low-bandwidth functionality has meant ensuring accessibility in areas with intermittent connectivity. With downloadable resources, this approach empowers participants in conflict-affected regions, bridging gaps in capacity and resilience-building at scale.
  • Mobile-first solutions: Given the high mobile phone penetration in Sudan, SMS-based MHPSS and hotlines are widespread and seeing increased uptake. The Bahri Emergency Response Room, Cafa Development Organisation, Nada Alazhar, and Ahfad Trauma centre are among the actors offering specialised MHPSS through hotlines and telephone sessions.
  • Web-based and mobile apps: This represents a smaller but growing category that includes tools like telemedicine platforms for remote consultations (e.g., Sudan Telemedicine Emergency Programme), apps that guide session delivery and assessments (e.g., WHO’s Self-Help Plus), and digital hubs for training and coordination (e.g., the MHPSS Minimum Service Package and The MHPSS Network). Although uptake in Sudan seems lower for these tools than for phone- or messaging-based tools, the former nevertheless show strong potential to bridge care gaps, particularly in urban and peri-urban areas with higher digital literacy.

These digital MHPSS initiatives demonstrate local adaptation, addressing cultural nuances and idioms of distress. They also leverage familiar and widely used digital tools through a hybrid model that combines low and high bandwidth solutions with referrals to traditional face-to-face methods. This approach ensures MHPSS is more accessible to diverse populations and varied digital landscapes.

 


 

In regions with limited or unstable internet access, platforms like WhatsApp and Telegram play a crucial role. These apps can function effectively in low-bandwidth environments, allowing for the continuation of support groups and counselling services even when internet connectivity is poor. Notably, WhatsApp is accessible without an internet subscription for some networks in Sudan, making it an invaluable tool for reaching wider populations. For areas with no or limited internet access, low-tech solutions (SMS, IVR, and hotlines) come to the forefront. This mobile-first approach capitalizes on Sudan’s high mobile phone penetration, enabling widened access to MHPSS services, while the hybrid approach helps in navigating infrastructure and cultural barriers as well as varying levels of digital literacy.

As one MHPSS coordinator noted:

 

“We’re using digital platforms to build up community response and deliver basic MHPSS. That puts the reach beyond what we could do with our limited number of specialists.”

 

Importantly, these digital initiatives offer anonymous and discreet access to MHPSS, enabling individuals to seek help without fear of social repercussions or exposure. Still, in low-trust, low-literacy settings, limited awareness of data rights, gendered access barriers, and lack of privacy protections can exclude or endanger vulnerable users. Inclusive design, strong data safeguards, and community participation must be non-negotiable foundations.

 

Multilayered and multisectoral: Rethinking MHPSS systems

The findings also emphasize that effective MHPSS interventions cannot operate in silos. Digital tools must be integrated into broader health and humanitarian systems, addressing not only individual needs but also the social and structural determinants of mental health.

  • Multilayered approach: Drawing on the socio-ecological model, the study highlights the need for interventions at multiple levels — individual, community, institutional, and broader policy. For instance, SMS campaigns addressing stigma work best when paired with community-based awareness efforts, institutional support for mental health services and policy changes that prioritise MHPSS in humanitarian/crisis response.
  • Multisectoral response: Mental health cannot be separated from broader humanitarian needs like shelter, food, and education. By embedding digital MHPSS into cross-sectoral programming — such as integrating mental health modules into livelihood training or e-health platforms — interventions become more sustainable and holistic.
  • Balancing immediate and long-term goals: While low-tech solutions like phone hotlines meet urgent needs, they should be paired with investments in infrastructure and digital literacy to build long-term resilience.

A systems-oriented paradigm recognizes that mental health is not just about clinical care; it’s about addressing the complex interplay of factors that shape well-being. Digital tools must complement, not replace, in-person services, creating a cohesive ecosystem of care. But this also entails addressing the fragmentation of the humanitarian system and fostering increased coordination and collaboration to stretch limited resources further.

 

Key recommendations

These findings offer valuable insights for implementing and scaling digital MHPSS interventions, both in Sudan and across the EHAGL region:

  1. Context is paramount: Digital interventions must be tailored to local realities, considering cultural norms, language, and technological infrastructure.
  2. Co-create with communities: In low-resource and emergency settings, this requires adaptive, participatory approaches that prioritize meaningful inclusion and practicality. Employing robust frameworks such as continuous feedback loops makes interventions relevant and responsive to shifting needs.
  3. Invest in targeted inclusive solutions: Targeted initiatives to bridge digital divides, focusing on inclusive approaches for marginalized groups, include: digital literacy training for both displaced communities and humanitarian actors, addressing specific needs of women, LGBTQIA+, older adults and other marginalized groups; and investing in infrastructure and accessible technologies.
  4. Prioritize privacy and safety: Robust data governance frameworks and culturally sensitive, accessible consent processes are essential to protect user information and build confidence in digital tools.
  5. Adopt hybrid models: Combining high-tech and low-tech solutions with traditional face-to-face support ensures broad accessibility, particularly in resource-constrained settings.
  6. Leverage evidence and existing tools: Building on proven and familiar tools can accelerate impact.
  7. Integrate into systems of care: Align digital MHPSS with broader health and humanitarian systems to enhance sustainability and impact.

These recommendations emphasize the importance of a nuanced, context-sensitive approach that balances immediate needs with long-term goals for promoting mental health. While these insights are drawn from Sudan’s experience, their implications extend across the EHAGL region. Countries with higher digital readiness, like Kenya, can serve as testing grounds for high-tech solutions, while contexts like South Sudan underscore the need for low-tech accessibility.

The research also highlights the value of regional collaboration. Shared learning across borders — whether through pooled resources, shared platforms, or coordinated policies — can amplify the impact of digital MHPSS interventions. A regional perspective recognizes the interconnected nature of displacement and the need for scalable, adaptable solutions that transcend individual crises.

Technology with a human touch

Sudan’s story is both a warning and a beacon. It shows the devastating mental health toll of displacement but also the extraordinary resilience of communities when given the right tools. Digital MHPSS can be a vital lifeline, bridging gaps that traditional systems cannot.

As the research underscores, the future of digital MHPSS lies in its ability to combine innovation with intention. Technology must not only reach people but resonate with their realities. It must be co-created, inclusive, and deeply embedded in the social fabric of the communities it serves.

Sudan’s MHPSS innovation journey is far from over, but it offers a roadmap for what’s possible when digital tools are wielded with care, when interventions are rooted in equity, and when humanity drives innovation.

For humanitarian actors, policymakers, and advocates, this research is a call to action: to reimagine mental health support for people forced to flee, to embrace nuance, and to ensure that no one is left behind.