Designing a culturally responsive digital mental health E-clinic for women and adolescent girls in Jordan: A qualitative study
Mohammad Alyahya, Khulood Shattnawi, Nihaya Al-sheyab, Yousef Khader, Heyam Al-ShhabIntroduction
Psychological distress among women and adolescent girls is a public health concern in low- and middle-income settings, where social adversity, stigma, displacement, and health-system constraints can hinder recognition and care. In Jordan, little is known about how healthcare providers recognize and respond to psychological distress within maternal, reproductive, and adolescent health services, or how they perceive culturally responsive digital mental health support. This study explored providers’ perspectives, barriers to recognition and response, and the potential role of a digital mental health e-clinic.
Methods
An interpretivist qualitative design using focus group discussions and in-depth interviews was adopted. A semi-structured guide explored clinical recognition of distress, service constraints, referral pathways, training and role-related challenges, and requirements for digital support. Audio-recorded Arabic data were transcribed verbatim, anonymized, and analyzed using reflexive thematic analysis.
Results
The dataset comprised eight focus group discussions and four in-depth interviews. Providers recognized psychological distress through clinical observation, interpersonal cues, and professional experience, particularly during perinatal care. However, limited mental health training, heavy workloads, unclear professional authority, uneven institutional capacity, and fragmented referral pathways constrained assessment, documentation, and action. Participants viewed structured screening as an adjunct to clinical judgement for identifying individuals who may require further assessment and referral, but not as a diagnostic tool. They support digital tools when embedded within functioning care pathways and accompanied by professional training, supportive supervision, clear escalation procedures, confidentiality safeguards, and access to services .
Conclusions
A culturally responsive digital mental health e-clinic may strengthen recognition, documentation, triage, referral, and continuity of care when integrated with clinical judgement and existing services. Digital tools should complement, not replace, professional assessment or specialist care. Improving mental health care for women and adolescent girls requires coordinated clinical, educational, service-level, and structural responses that address individual needs and wider social conditions contributing to psychological distress.