Evaluating digital mental health interventions for Middle East and North Africa children and adolescents affected by armed conflict: A systematic review

Children and adolescents in the Middle East and North Africa (MENA) region experience high rates of psychological distress due to armed conflict and displacement, with limited access to traditional mental health care. This has led to increased interest in digital mental health interventions (DMHIs) as a potential solution. This systematic review evaluates the effectiveness of DMHIs in reducing PTSD, anxiety, and depression symptoms, as well as improving overall wellbeing in MENA children and adolescents affected by armed conflict. It also explores barriers and facilitators to implementation in conflict-affected and displacement settings. The review included studies involving children and adolescents ages (5–18), from MENA countries affected by armed-conflict or displacement. We conducted a systematic search of PubMed, PsycINFO, CINAHL, and gray literature using a structured Population, Intervention, Outcome (PIO) framework, along with expert consultations, following PRISMA guidelines. The quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT), and findings were synthesized narratively. Ten studies on digital games, telehealth, and online interventions showed significant reductions in PTSD, anxiety, and depression, with medium to large effect sizes. Gamified interventions in schools and healthcare settings had the highest engagement. Key barriers included infrastructure, digital illiteracy, and stigma, while facilitators were cultural adaptation and integration into existing systems. DMHIs are a promising strategy for addressing mental health needs in conflict-affected children and adolescents. Future efforts should prioritize cost-effective, offline compatible models and greater integration into education and healthcare systems for sustainability • Digital mental health interventions reduce PTSD, anxiety, and depression among conflict-affected youth in MENA. • Gamified interventions are highly effective for trauma recovery and well-being improvement. • Successful digital mental health interventions rely on strong cultural adaptation and community support. • Technological barriers and stigma limit the effectiveness of mental health interventions. • Limited research on mental health interventions in conflict zones affects outcome generalizability.