Delivering Psychiatric Assessment and Treatment in Low-Resource Settings: A Potential Model for Neurodevelopmental Disorders, Developmental Disorders, Psychiatric Morbidity, and Complex Biomedical Multimorbidity
Authors: Cawthorpe David 
Published: February 2025

Addressing life-span neurodevelopmental disorders, psychiatric morbidity, and complex biomedical conditions, in both traditional urban and low-resource settings, requires an integrated, cost-effective, and scalable approach that adapts to local infrastructure and cultural contexts. Many urban and rural communities face shortages of mental health professionals, leading to significant barriers in psychiatric assessment and treatment accessibility. This paper proposes an integrated and sustainable framework. The model incorporates community-based care models, task-shifting strategies, and digital innovations, including AI-assisted diagnostics, telepsychiatry, and wearable health monitoring. The model’s framework is structured around four key pillars: (1) Accessible and Scalable Psychiatric Assessment, (2) A Multi-Tiered Treatment Model, (3) Managing Complex Biomedical Multimorbidity, and (4) Policy and Sustainability Strategies.

The implementation strategy follows a tax reform model to direct government tax revenues including those recovered at the community level into mental health infrastructure, workforce training, and digital health solutions. The four-phase approach is modeled a remote community of 100,000 people and includes infrastructure development (Years 1-2), community-based mental health expansion (Years 3-5), AI and digital psychiatry integration (Years 6-8), and full policy implementation (Years 9-10). Each of the models phase integrate evidence-based interventions, including but not limited to task-shifting psychiatric care to community health workers (CHWs), expanding school-based screenings for neurodevelopmental disorders, implementing AI-powered mental health surveillance systems, clinical outcome measurement, and optimizing predictive analytics to allocate resources efficiently.

A cost-benefit analysis demonstrates that employing a tax reduction model up to an initial $35 million investment in local health and mental health infrastructure, workforce training, and AI-based psychiatry yields a projected $265 million return over ten years, reflecting a 7.5x return on investment (ROI). The integration of telepsychiatry and AI-driven diagnostics is projected to increase psychiatric consultation rates by 20%, reduce untreated mental illness costs by $10 million annually, and generate $100 million in productivity gains through workforce retention and reduced absenteeism.

By embedding health and mental health services within communities via tax reduction with access to tax revenue supported local primary healthcare systems that leverages digital health advancements, this model ensures the long-term sustainability of health and psychiatric care while maximizing economic productivity and social resilience. Through tax incentives, public-private partnerships (PPPs), and innovative financing mechanisms, this approach fosters inclusive, community-led mental health support, reducing the long-term financial burden on government healthcare systems. The findings highlight the potential of a tax-incentivized, technology-driven psychiatric care model to create scalable, self-sustaining, and culturally relevant mental health solutions for underserved populations worldwide. Limitations are noted.