Antony Mwaniki Kuru final Project Documentation 1122

ACKNOWLEDGEMENT I acknowledge the Almighty God for guiding me through the whole process of developing my project. I would like to appreciate and give thanks to the people who have assisted during this period. I acknowledge my parents and friends for their support during this time as they have made it possible to still do the research necessary for the project. I also acknowledge my supervisor, Mr. Patrick Gikunda for his guidance and continuous support throughout the project. The university should also be recognized for giving this opportunity to do this project and trying to adapt to the current circumstances under which the projects will be done. 3

4.1 Introduction ................................................................................................................................................ 23 4.2 Requirement Analysis ............................................................................................................................ 23 4.2.1 Functional Requirements ................................................................................................................... 23 4.2.2 Non-functional requirements ............................................................................................................. 24 4.3 Requirement Gathering ............................................................................................................................. 24 4.3.1 Economic Requirements ..................................................................................................................... 24 4.3.2 Security Requirements ....................................................................................................................... 24 4.3.3 Observation Analysis. ......................................................................................................................... 24 4.4 Questionnaire Analysis .......................................................................................................................... 25 4.5 Interviews Analysis ................................................................................................................................ 27 4.6 System Analysis .......................................................................................................................................... 28 4.6.1 Use Case Diagram ............................................................................................................................... 28 4.6.2 Data flow diagrams ............................................................................................................................. 29 4.6.3 Context diagram ................................................................................................................................. 32 4.6.4. ERD diagram ...................................................................................................................................... 33 4.6.5 Flowchart diagram .............................................................................................................................. 35 CHAPTER FIVE: TESTING AND IMPLEMENTATION ................................................................................ 36 Introduction ...................................................................................................................................................... 36 5.1: Testing ...................................................................................................................................................... 36 Test Case 1: User sign up page .................................................................................................................... 38 Test Case 2: User sign in page ..................................................................................................................... 39 Test Case 3: booking appointment .............................................................................................................. 40 Test case 4: Checking appointments booked .............................................................................................. 41 Test case 5: online counselling .................................................................................................................... 42 Test case 7: make payment ......................................................................................................................... 43 Support and Training ................................................................................................................................... 44 Maintenance ................................................................................................................................................ 44 IMPLEMENTED SYSTEM COMPONENTS ...................................................................................................... 45 Implementation ............................................................................................................................................... 47 CHAPTER SIX: CONCLUSION, LIMITATIONS AND RECOMMENDATION ............................................................... 48 6.1 Conclusion .................................................................................................................................................. 48 APPENDEX ............................................................................................................................................................ 51 4.1 User requirements ................................................................................................................................. 51 6

CHAPTER ONE 1.1 INTRODUCTION Mental disorders or illnesses are conditions that affect your thinking, feeling, mood, and behavior which can be occasional or long-lasting thus affecting your ability to relate to others and function each day as stated by (mental disorders, 2020) There are different types of mental illnesses or disorders in which everyone has a risk of developing irrespective of their gender, age, or ethnicity they include: anxiety disorders, psychotic disorders, substance abuse disorders, personality disorders and mood disorders such as bipolar disorder or depression. There are various ways of diagnosing whether a person is suffering from a mental disorder. Treatment of mental illness depends on a patient’s mental disorder and the state in which they are in thus specific treatment plans for each patient. World Health Organization has determined that there is a burden of mental health disorders worldwide and there is no adequate response by health systems. These have resulted in a gap between treatments needed and the provision of mental healthcare. In low – and middleincome countries about 76% to 85% of people with mental conditions or illness receive no treatment for their illness. According to a study by Institute Health Metrics and Evaluation in 2017 it was estimated that 729 million people lived with mental health disorder which is about 10.7% of people globally (Roser, 2018) In Kenya the government statistics indicate at one point, one in every four Kenyans suffers from a mental disorder in their lives which reflects about 11.5 million people. There few medical personnel and facilities capable of handling the diagnosis and treatment of these mental issues. This impacts the accessibility and availability of mental health care to mentally ill patients. (Kanyoro, 2020) In Kenya it is estimated there about 12 million people living with mental disorders. Nairobi has the highest numbers among all the forty-seven counties in the country with 20, 353 reported cases of hospital visit due mental illness. A survey by KNBS- Kenya National Bureau of statistics which was released in December 2019 reported that about 104,615 cases of mental disorders were handled in Kenyan’s hospitals. (Mwangi, 2020) People spend a lot of time searching for doctors and hospitals/facilities providing mental healthcare that is getting their particular locations and getting approval as their patients it is rough and time-consuming. Booking test needed and making appointment’s also poses a 9

1.4.2 Specific objectives I expect to achieve the following specific objectives: I. To create a module that facilitate booking of appointments with available medical professionals or institutions offering mental healthcare. II. To create a module that facilitates treatments of mental conditions through online counselling or teletherapy. III. To create a module which provides information about mental conditions and support groups where people can communicate and share about their conditions. IV. To enable making payments for mental healthcare services offered. 1.5 Justification As a result of the challenges people with mental conditions face accessing mental healthcare services in the country, I conducted a research to determine the possible solutions to these problems thus developing a mobile web-application to be a potential solution to the problems that people face. The system will ensure timely access to healthcare for people with mental disorders, and ensure that the right patients get the right care and treatment, at the right time, and in the right setting. This will be achieved as the system will: enable patients/users to access, identify and select mental health facilities and doctors available. The system will also provide relevant information needed and provide a support group for patients. Also, it will enable patients to book tests and make appointments needed thus getting access to test, diagnosis and treatment they require to manage their conditions. The research also contributed in the gathering of requirements for the system from the intended users . 12

2.1.3 Case study two: BIG WHITE WALL APPLICATION This is an e-mental health application based in the United Kingdom Big White Wall is a community application where people suffering from different mental health illnesses come together, share and talk about their challenges or problems with support from trained doctors or therapists according to (Top 10 Mental Health Apps, 2020). Big White Wall its application is commissioned by over I50 organizations globally, they are an online service that facilitates access to millions of people with mental issues such as anxiety and depression (About us, 2020). The app a peer-to-peer community offers anonymous conversation which can scale to any population clinically managed and designed to support people 24/7 by trained medical practitioners The application is comprised of the following feature: • Information; reference articles and information about mental health • Self-monitoring where users can do self- assessment test. There is also a range of selfadministered clinical tests, guides, and tips to improve wellbeing, including articles on self-esteem, sleep, relationships, and many more as stated by my health apps website (Big White Wall, n.d.) • Discussions boards and support group modules where users can create pictures or images to express their feelings or using adds and words in the community wall. This facilitates users to connect with people like having similar conditions or friends and family. Users can also register for online therapy courses covering issues like anxiety attacks and sessions to manage their conditions by signing up for teletherapy for example via audio or instant messaging with experienced therapist and therapist. The services that the application provide have an active forum with a 24/7 support forum professionals who are trained and vetted. Where these services can be accessed via smartphones, laptops, or computers with internet services. The users can talk or share anonymously with other members and participate in a one-to-one or group therapy with a therapist. The application is for everyone wanting to manage and improve their mental health from anyone aged 16 and above. Users can express themselves freely and openly as it is completely anonymous. After creating an account at their website one can download an application for their apple or android smartphones Their professionals such as the therapist they are at all times online to provide support and moderate services. According to ---95% Big White Wall members feel better after using Big white wall and 73% share an issue for the first time according to (Big White Wall, 2020). Big white wall application is limited to self-diagnosis and also there is no or minimum physical professional involvement that is treatment such therapy is online. My proposed application will facilitate the booking of diagnosis at available facilities and also provide options for making one-on-one doctor/medical professionals appointments. 15

Medical professionals or facilities listing and profiles so as patients can identify and connect with a doctor or hospital based on their conditions and location. The listing of different medical professionals or facilities will help users make informed choices. Booking and making of appointments; an appointment making and booking feature which will facilitate users to book online or in-person treatments such as psychotherapy, required tests and diagnosis at a facility/hospital of their choosing. Provides online counselling and therapy enabling users to consult with medical professionals like therapists via various modes which will include text, video, or voice consultations. Support group or discussion forum where users can share, talk, and communicate with other patients. Like a group therapy but on an online platform which will be anonymous to create a safe space or a community where users can feel to share and talk about mental health illness or related issues. 18

• Implementation and maintenance of the product is done as the last steps. Below is diagram of the steps involved. 3.2.1.1.2 Figure 2. prototyping method steps involved 3.3 System design- Software development procedures. In this section, I will be defining elements of the Afyamedex the e-mental health system which includes modules, components, architecture, and interfaces. I will design the Afyamedex mobile web-based application as per the requirements I gathered from the users. The layout and design will be user-friendly. 3.4 Preliminary Data Processing and analysis . Section describes the data analysis process which consists of the following phases: • Data Requirements Specification; identify the data required for analysis • Data Collection; gather the data required using methods such as questionnaires • Data Processing; organize the data collected for analysis • Data Cleaning; correct errors which may be present in the data • Data Analysis; use various data analysis techniques to interpret the data and derive conclusions. • Communication to the results or the data analysis using data visualization techniques like pie charts or tables The data for my research will be gathered through interview, observation and existing resources from the secondary collection such as articles will be processed and analyzed. 21

Chapter 4: System analysis and Design 4.1 Introduction This section consists of the analysis and design of the Afyamedex. Discussed below is the system requirements which provide the functional and Non-functional requirements of the System. The design of the system is outlined going into details about the features and operations of the systems 4.2 Requirement Analysis 4.2.1 Functional Requirements This are the process the system will perform. They include the following: • Enable users to register to an account and login using their credentials this consist of patients, medical professionals and institutions. • Provide information about mental conditions and their corresponding symptoms and treatments. • Facilitate users with mental health condition to view a listing of available medical professionals and institutions. • Enable patients to choose a medical professional based on their specialization. • Facilitate booking of appointments with available medical professionals and hospitals/institutions. • Enable users to communicate with each other through texts messages. • Facilitate online counseling of patients by available medical professionals. 4.2.2 Non-functional requirements • Confidentiality; Afyamedex secures users information by keeping their information confidential. • Security; by authenticating users through a password security is achieved as only authorized can access the system. • Ease of use; as Afyamedex is clear and simple thus easy to use • Understandable; Afyamedex is easy to understand by new users as it contains very user-friendly interfaces. 22

4.3 Requirement Gathering 4.3.1 Economic Requirements If the proposed System will be implemented, one will need an internet-enabled device to enable to access services provided and storage of data. 4.3.2 Security Requirements Security and control over the data is necessary in creating an application. This is to minimize the threat of unauthorized access. 4.3.3 Observation Analysis. From my observation; People with mental health conditions in Kenya have no access to a platform such as a support group or a discussion forum where they can share, talk and communicate anonymously about their conditions; no safe space to share their challenges, feelings, or other related issues which are free of judgment. From my data about 84% of mental health patients have no access to support groups or forums, about 10% have access but not all the time and the rest 6% are not confident about sharing and talking as the existing platforms are not anonymous or their judgment from other people. 4.3.3.1 Figure 3 4.4 Questionnaire Analysis Below if the data collected from the questionnaire I used, out of the response to the questions that I had prepared. 23

o The objective of the question is to determine the accessibility of information about mental conditions.  The below question was focused on determining number of people with mental conditions Figure 4.4.2  This question was meant to find out the use of mobile applications or web-based systems to access mental health services. Below is a comparison of people who use emental health systems and those who don’t. 24 Figure 4.4.1 can you access information about mental conditions and their corresponding treatments ? no yes maybe Do you have a mental condition or know someone suffering from any mental condition? yes no

4.5 Interviews Analysis I conducted interviews and asked the following questions: Sample questions prepared for my interviewees; • Can you get access to relevant information and data about mental conditions or illness and their corresponding diagnosis, test, and treatments? • How can you get access to a listing of available and certified mental health professionals such as psychologists and facilities or hospitals based on their specialization? • How and where to make appointments with mental healthcare professionals? • How and where to book diagnosis and tests for mental health condition to determine your status? • Do you know a support group or discussion forum where you can share, talk, or communicate with other people about mental health conditions and related issues? • Do you know a mobile application or web-based system offering mental health care services? • Can you make an appointment using your phone with mental healthcare provider? 25 Figure 4.4.3 0 10 20 30 40 50 60 70 80 90 NO Yes COMPARISON Reading in %

4.5.1 Table 1 Question Number of responses Responses Can you get access to relevant information and data about mental conditions or illness and their corresponding diagnosis, test, and treatments? 7 Yes-4 No -3 How can you get access to a listing of available and certified mental health professionals such as psychologists and facilities or hospitals based on their specialization? 8 Searching over the internet-4 Manually visiting institutions or hospitals-3 Asking other people-1 How and where to make appointments with mental healthcare professionals? 5 Manually visiting an institution/hospital Do you know a support group or discussion forum where you can share, talk, or communicate with other people about mental health conditions and related issues? 7 Yes -1 No-6 Do you know a mobile application or web-based system offering mental health care services? 8 Yes-2 No-6 4.6 System Analysis 4.6.1 Use Case Diagram Diagram below shows the actors and the use cases and the relationship between the them. It is a diagrammatical representation of how the Admin, patients, medical professionals and institutions will interact with the System in order to make the Afyamedex efficient, reliable, and affordable. 26

Actors Below is a list of actors who will interact with the system: • Admin • Patient • Medical professionals • Institutions/hospitals 4.6.1.1 Figure 4.6.2 Data flow diagrams 4.6.2.1 figure DFD level o Level O 27

Level 1 4.6.2.2 figure DFD level 1 28

4.6.3 Activity Diagram Figure 4.6.3.1 activity diagram The diagram describes the flow activities when a administrator engages the system. 29

4.6.4 Context diagram Figure 4.6.4.1 context diagram 30 User is logged in Display dashboard Users and cond ition posted management Manage users DATABASE Stores details Stop Star Input login details Check details from databas User not logged in redirect to sign up

4.6.5. component diagram Figure 4.6.5.1 component diagram 31

32 Medical professional Input data and gets Information. Patient input data and receive information response request Database Medical professional Patient SYSTEM

Figure 4.6.6.1: Entity Relationship Diagram . 4.6.7 Flowchart diagram 33 4.6.6 ENTITY RELATIONSHIP DIAGRAM Medical professional User full name User email Username G ender Password Registers Posts conditions info Approve appointments Gives online counselling SYST EM Support groups Online counselling Generate reports Patient User full name User email Username G ender Password Registers Views conditions Book appointments Pays for services

Figure 4.6.7.1 flowchart diagram This diagram explains how a patient interacts with the system. 34

CHAPTER FIVE: TESTING AND IMPLEMENTATION Introduction The focus of this chapter is to substantiate the e-mental health system quality by investigating and examining the progress of the system using a group of activities, that is systematically subjecting the system to defined procedures in a controlled environment to provide information about the quality and actual performance levels of the system. This will enable to determine whether the system is usable. 5.1: Testing Software testing is the method to check whether the actual software product matches expected requirements that’s is verify and validate the software to confirm that it meets expected user needs and specifications, ensuring it is free of errors. Functional tests and non-functional tests were used to determine that the system looks and behaves as expected. Below are some of the testing methods used. Unit testing Software testing method where individual units or components of a software are tested. That is a testing method in which individual software modules or components are tested to determine where there are any issues. Unit testing is concerned that each component or module is functioning correctly by identifying, analyzing and fixing errors/defects. This includes ensuring a successful user log in for authorized uses, entering the property details as well as modifying them Integration testing This is the process of testing the interface between two software units or module. After each unit is thoroughly tested, it is integrated with other units to create modules or components that are designed to perform specific tasks or activities. These are then tested as group through integration testing to ensure whole segments of an application behave as expected. By using this test i verified that individual modules integrated were able to work together and their interactions seamless. After user’s registration details, booking of appointments were reflected in the database. 35

Table 2. Integration Testing Data Test Test Area Expected Results Actual Results Integration Test Modules Relationships Different modules in the system working together in the expected way The modules were able to work together and produce the expected results System Testing This method was used to evaluate the completed and integrated system, as a whole, to ensure it meets specified requirements. The functionality of the software is tested from end-to-end to confirm that the whole system meets the requirement specifications expected. Table 3: System Testing Data Test Test Area Expected Results Actual Results System testing Entire system The system meeting all the objectives proposed. The system was able to meet all the objectives that had been proposed Acceptance Testing : Acceptance testing was done deploying and delivery of the system to assess whether or not the final system was ready. It involved ensuring that the product is in compliance with all of the original business model and that it meets the end user’s needs. This required the product be tested by end users. The tests result included understandability, memorability and ease of use. 36

Table 4: Acceptance Testing Data Test Test Area Expected Results Actual Results Acceptance Testing System’s acceptability and usability Users being able to navigate through the application with minimal effort. Users were able to use the system with no assistance. 5.2 Test Cases A test case is the specification of the inputs, execution conditions, testing procedure, and expected results that define a single test to be executed to achieve a particular software testing objective, such as to exercise a particular program path or to verify compliance with a specific requirement. The development of the system involved several tests, which included; Test Case 1: User sign up page This test is to verify that the sing up(registration)page is functioning correctly. The limit of the Password should be more than 8 characters (alphanumeric). Required fields are: 1. Full name 2. Email 3. Username 4. Gender 5. birthday 6. Password 7. Confirm Password Test procedure - Enter the required inputs then click the submit button Expected results; after filling the required fields with the correct inputs, the new user has to choose how to use the application either as patient, medical professional or an institution. If the new users fill in the required fields with the wrong inputs error messages are displayed to notify the user to fill in the correct details so as to register. Example when user enters a password that is less than 8 alphanumerical characters an error massage is displayed that’s “Too short” thus the new users must meet the required password standard to successfully register as a user. 37

Status: Test passed . Test Case 2: User sign in page This test was carried out to verify that the user’s login page was functioning as expected. At the bottom of the page there is a “forgot password” option where the user can use to reset password. Required fields are username and password. inputs include; username and password which were inputted during registration necessary to authenticate user Test procedure - Enter the username and password then click the submit button. Table 5: Test Data Test data - username, password. 38

Expected results - The user logs in on entering correct username and password. Actual results - If the user details are correct, the user logs in, otherwise he/she is denied access to the system during login. Status: Test passed . Test Case 3: booking appointment Test procedure: clicks the menu tabs at the upper left-hand side of the home page window, to display various activities. select professionals/institution, choose a medical professional/institution, select book which will display a page to book an appointment. Fill in the required info then click book. Required inputs: • Subject • Date • Time • Appointment type • duration 39

Expected result. Nice! You have reserved your place Status: Test passed. Test case 4: Checking appointments booked Test procedure: click the back button to view the home page Click the tabs on the upper left corner to display various activities and select my appointments to check the booked appointments. Expected result. List of appointments booked is displayed Status: Test passed. 40

Test case 5: online counselling Test procedure: Navigate to menu bar on the home page then click on appointments, select on the appointment booked (must be approved by medical professional indicated by green), click on the “join” button to join meeting. Expected results: meeting starts, which is video and audio enabled. Status: test passed 41

Test case 7: make payment click the back button to view the home page Click the tabs on the upper left corner to display various activities and select my appointments to select appointment to make payment and click on the appointment which will display a page to make the payments, fill in the payments details and confirm Expected result: your payment was processed. Status: test passed 42

Test case 8: posting test result (comments and notes) Test procedure: Navigate to menu bar on the home page then click on appointments, select appointment where the test was carried out and post test results (comments and notes) Expected results: comments and notes posted. Status: test passed 43

44

45

Support and Training The application is meant to be used by the general public; it requires minimal to no training at all for a first- time user as the application is easy to use. Maintenance The fact that the application is using a newly introduced platform in the field of IT, the application will regularly be updated to support the new releases and libraries that will updated so as to work more efficiently and also to provide additional features in the future that are useful to this domain. IMPLEMENTED SYSTEM COMPONENTS WEB APPLICATION DASHBOARD Once an admin is authenticated to the system, they land on the dashboard. On this page the user is able to see the most recent activities that have taken place in the system. Figure below shows a screenshot of the dashboard. Registered users’ screen The administrators will be able to see all users registered on the application. They can be able to disable or enable the registered users. These users are registered directly from the mobile web application. 46

Administrator Reports panel A summary of payments is provided for the administrator. Condition posts. This page shows the mental conditions information posted by medical professionals. The administrator is able to disable or enable a condition posted. 47

Implementation Front End Development and implementation - Ionic Framework (using React components), Capacitor to leverage native device resources, Cascading Style Sheets and JavaScript. Back End Development and implementation - Node.js (Express server), Mongoose to define Mongo DB schemas, PostgreSQL and node-postgres to PostgreSQL database server Implementation Strategy- Agile, planned objectives on a backlog and incremental implementation and testing of features over time. The tools which were used for development included visual basic code for developing the web application, text editor for the web application, visual paradigm for designing the UML diagrams. I involved the users as well as my supervisor throughout the process which helped increase the likelihood of user acceptance of the final implementation product. 48

CHAPTER SIX: CONCLUSION, LIMITATIONS AND RECOMMENDATION 6.1 Conclusion In conclusion, during the start of the project, the main aim was to develop an e-mental health system that improves accessibility of mental healthcare services provided for treatment and management of mental health conditions. By providing information on mental conditions, facilitating an easy way of booking appointments, online supports group for people with mental conditions, treatment of mental conditions through talk therapy or online counselling and enabling payments for services provided. A research was conducted and e-mental health system; Afyamedex mobile web application and web-based system was developed. the system enables patients/users to access, identify and select mental health facilities and doctors available. The system also provides relevant information needed and provide a support group for patients. Also, it enables patients to book tests and make appointments needed thus getting access to test, diagnosis and treatment they require to manage their conditions. Therefore, I declare the systems achieves its purpose. 6.2 Limitations. The various challenges or limitations faced during the research and development of my project include: Unreliable internet access. The project required extensive research which more than often involved use of the school internet which was not really reliable. Also, the project required internet connectivity so as to perform its operations as expected. Uncooperative respondents during data collection. Some didn’t want to answer questions while others were reluctant in providing some information required for the research. This hampered the data collection process. Challenges in adapting to new changes and updates in the programming ide used. This is with regards to the platform used. Android studio generally has a number of updates to which require time a reliable internet speed to accomplish the required update. Covid-19 pandemic also had a negative impact during this exercise. Also lack of funds to purchase a Mpesa till number. 6.3 Recommendation There are many people with mental conditions, and they face challenges while accessing mental healthcare services provide by mental healthcare professionals or facilities. Booking of appointments for treatment, 49

tests or diagnosis have been done manual for a long time since most mental healthcare provides do not use or leverage e-mental health systems such Afyamedex. I recommend mental healthcare providers to adopt technologies such e-mental health systems as E-mental health systems are an increasingly important factor for the treatment of mental disorders include applications and web-based systems that address the treatment and diagnosis gap in mental health. These systems use technologies such as websites and smartphones with support of the internet to deliver mental healthcare to people with mental disorders in time therefore easy access to services they require to treat and manage their conditions. The use of these applications is very helpful because it leads to better communication between doctors and patients and help to enhance the overall treatment quality. Healthcare information systems gives support and deliver healthcare services meeting the health needs of their user thus health improvement. Further, I recommend mental healthcare providers to embrace cloud computing technology and hence host the application on the cloud so that they enjoy the benefits of Software as a Service. Future researchers may add the following to their future research work: To create a platform incorporating all the mental healthcare services on one platform. A consistent module which will be tracking the patient’s treatment progress over time and selfmonitoring where users can do self- assessment test. Also create a module where there is a range of self-administered clinical tests, guides and tips to improve wellbeing. 50

References about. (2020). Retrieved from better help: https://www.betterhelp.com/about/ About us. (2020). Retrieved from BWW: https://www.bigwhitewall.com/about-us/?lang=en-us Anderson, D. (2020). TalkLife . Retrieved from common sense media: https://www.commonsensemedia.org/app-reviews/talklife Big White Wall. (n.d.). Retrieved from My health apps: http://myhealthapps.net/app/details/ 323 /bigwhitewall Big White Wall. (2020). Retrieved from my health apps: http://myhealthapps.net/app/details/323/big-white-wall Doyle, A. ( 2019 , October 22). the Best Depression Apps 2020 . Retrieved from Healthline: https://www.healthline.com/health/depression/top-iphone-android-apps#talklife Hintze, G. (2017, august 19). 8 Online Alternatives That Are Cheaper Than Traditional In-Person Therapy. the Might. Retrieved from the might: https://themighty.com/2017/08/affordableonline-therapy- cheap/ Kanyoro, D. K. (2020). The State of Mental Health in Kenya. Retrieved from university of Nairobi research: https://uonresearch.org/vvc/article/the-state-of-mental-health-in-kenya/ Lal, S. (February 10 2019). E-mental health: Promising advancements in policy, research, and practice. healthcare management forum. mental disorders. (2020). Retrieved from Medline plus: https://medlineplus.gov/mentaldisorders.html Mwangi, V. (2020, January 8). ten counties most affected by mental illness in Kenya. Retrieved from soko directory: https://sokodirectory.com/2020/01/ten-counties- mostaffectedbymentalillness-in-kenya/ Pros and Cons of Mental Health App. (2019, April 7). Retrieved from Transformations: https://www.mytransformations.com/post/pros-and-cons-of-mental-health-apps Roser, H. R. (2018, April). Mental Health. Retrieved from Our World in Data: https://ourworldindata.org/mental-health Rubies, G. (2020, January 1). E-mental health applications for depression: an evidence-based ethical analysis. Retrieved from springer link: https://link.springer.com/article/10.1007/s0040601901093-y#citeas TalkLife. (2020). Retrieved from crunchbase: https://www.crunchbase.com/organization/talklife#sectionoverview Talksapce. (2020). Retrieved from crunchbase: https://www.crunchbase.com/organization/talkspace#section- overview Top 10 Mental Health Apps . (2020). Retrieved from psychiatry Advisor: https://www.psychiatryadvisor.com/slideshow/slides/t o p - 1 0 - ment a l - heal t h - app s / 51

APPENDEX 4.1 User requirements 4.1.1 Table 6: User requirement Hardware Processor Core i5 processor RAM 4GB Hard disk 500GB Flash drive 8GB Software Operating system Windows 10 pro Visual studio code MongoDB Git repository, Ionic framework and Node.js Web browser and antivirus 4.2 Budget The projects intended budget. This includes them items, number of items and their cost: 4.2.1 Table 7: BUDGET ITEM NO. OF UNIT COST PER UNIT (Ksh) TOTAL COST(Ksh) Computer 1 32,000 32,000 Hard disk 1 2,500 2,500 Internet connection - 4,000 4,000 Travelling cost _ 5,000 5,000 Printing and binding document _ 1200 1200 TOTAL COST 44,700 44,700 4.3 Project schedule 52

The projects run for two semesters from May – November. The Gantt chart below schedules the projects activities by allocating a specific time line for each activity. 4.3 Table 8: gnat chart Duration in moths Activity M ay Ju ne Ju ly Augu st September Octob er Novemb er Decem ber Janu ary Febru ary mar ch Project identification Proposal writing Proposal presentation Data collection Data analysis Project design Implementati on Testing Documentati on Presentation Sample codes. Singin page: import React , { useEffect } from 'react' ; import { IonButton , IonContent , IonPage , IonRow , IonCol , IonText , IonRouterLink , IonItem , IonLabel , IonInput , useIonViewDidEnter , useIonViewWillLeave } from '@ionic/react' ; import { Formik , Form } from "formik" ; import * as Yup from "yup" ; import { signIn } from '../http/users' ; import { useAppContext } from '../lib/context-lib' ; import { useHistory } from 'react-router' ; import useToastManager from '../lib/toast-hook' ; import FormFieldFeedback from '../components/FormFieldFeedback' ; import { setObject } from '../lib/storage' ; import { STORAGE_KEY , USER } from '../http/constants' ; import useMounted from "../lib/mounted-hook" ; 53

const loginSchema = Yup . object ({ username: Yup . string (). required ( "Enter your username." ), password: Yup . string (). required ( "Enter your password." ) }); const SignIn : React . FC = () => { const { setCurrentUser } = useAppContext () as any ; const history = useHistory (); const { onError } = useToastManager (); const { isMounted , setMounted } = useMounted (); const handleSubmit = async ( values : any , { setSubmitting }: any ) => { try { const { data } = await signIn ( values . username . trim (), values . password ); isMounted && setSubmitting ( false ); if ( data . accountType === USER . ACCOUNT_TYPES . ADMIN ) { return onError ( "Admin log in disallowed. Try the web app." ); } isMounted && setCurrentUser ( data ); await setObject ( STORAGE_KEY , { currentUser: data , }); if ( data . accountType ) { history . push ( "/app" ); } else { history . push ( "/account-type" ); } } catch ( error ) { isMounted && setSubmitting ( false ); onError ( error . message ); } }; useEffect (() => () => setMounted ( false )); return ( < IonPage > < IonContent fullscreen > < IonRow className = "h100" > < IonCol className = "ion-align-self-center" > < IonText className = "ion-text-center" > < h1 > Sign In </ h1 > </ IonText > < Formik validationSchema = { loginSchema } onSubmit = { handleSubmit } initialValues = { {} } 54

> { ({ handleChange , handleBlur , errors , touched , isValid , isSubmitting }: any ) => ( < Form noValidate > < IonItem className = { touched . username && errors . username ? "haserror" : "" } > < IonLabel position = "floating" > Username </ IonLabel > < IonInput name = "username" type = "text" onIonChange = { handleChange } onIo nBlur = { handleBlur } /> </ IonItem > < FormFieldFeedback { ...{ errors , touched , fieldName: "username" } } /> < IonItem className = { touched . password && errors . password ? "haserror" : "" } > < IonLabel position = "floating" > Password </ IonLabel > < IonInput name = "password" type = "password" onIonChange = { handleChange } onIonBlur = { handleBlur } /> </ IonItem > < FormFieldFeedback { ...{ errors , touched , fieldName: "password" } } /> < IonRow > < IonCol > < IonButton color = "secondary" expand = "block" type = "submit" disabled = { ! isValid || isSubmitting } > { isSubmitting ? "Submitting..." : "Submit" } </ IonButton > </ IonCol > </ IonRow > </ Form > ) } </ Formik > < IonText className = "ion-text-center" > < p > < IonRouterLink href = "/reset-password" > Forgot password? </ IonRouterLink > </ p > < p className = "ion-no-margin" > Don't have an account? < IonRouterLink href = "/signup" > Sign up </ IonRouterLink > </ p > </ IonText > </ IonCol > </ IonRow > </ IonContent > </ IonPage > ); }; export default SignIn ; 55

QUESTIONNAIRE AFYAMEDEX QUESTIONNAIRE. This survey is part of the BSc BIT fourth-year project on the e-mental health system. If you wish to stop completing the survey at any time, please feel free to do so. Directions. We are interested in your views about mental health and mental healthcare services. Please read each question carefully and indicate your response by selecting the most appropriate choice. 1. Do have a mental disorder or illness? YES □ NO □ 2. Have ever been tested or diagnosed for mental disorder? YES □ NO □ If yes indicate where you got tested or diagnosed How did you book for the tests or diagnosis? (Tick to apply) At hospital/facility manually Mobile application Website 3. Do you know a person, friend or family member with a mental condition? YES □ NO □ If yes are they able to access mental healthcare services? YES □ NO □. Indicate how 4. Can you access a list and details of the available hospitals or facilities offering mental healthcare services at given location? YES □ NO □ If yes indicate how 5. Can you access a list and details of the available, licensed and certified medical professional and doctors offering mental healthcare services? YES □ NO □ If yes indicate how 6. Can you access information and data about mental disorders and their corresponding tests, diagnosis and treatments? YES □ NO □ If yes indicate how 7. Do you know any support group, discussion forum or group therapy session where you can share, talk and communicate with other people about your mental conditions? YES □ NO □ If yes indicate which group or forum How do you access the it? Fill in yes or no 56

Physical sessions Mobile application Website 8. Do you know or use a mobile application or web-based system that offers the following mental healthcare services? Complete the table by filling in yes or no. Informatio n About mental disorders View a list of mental professionals such as psychiatrists and their details View a list of mental healthcare facilities and hospitals and their details Book for tests and diagnosis Make appointments Support group/discussio n forum or group therapy Thank you for your cooperation . 57