Remarks y For all delivery formats listed in the recommendation, there is no inherent hierarchy or priority intended in the listing of delivery formats. y See ANX2 for further discussion of evidence for the brief, structured psychological interventions recommended in mhGAP for GAD and/or panic disorder. y While interventions that are provided by specialists or as guided self-help (either digitally or face-toface) are likely to demonstrate better outcomes than those provided in groups, by non-specialists, or as unguided self-help, the latter may be suitable for adults with anxiety disorders who either (i) do not have access to face-to-face psychological treatment provided by specialists or guided self-help psychological treatment or (ii) are not willing to access such treatments. y The choice of intervention format depends on available resources in the health system as well as individual preferences. y Self-help psychological treatment may involve information technology (IT)-supported self-help materials and/or paper-based self-help books or visual materials and can be guided by professionals or lay workers with varying degrees of support, or can be unguided. y Face-to-face brief psychological interventions delivered by service providers is human resourceintensive as it requires substantial provider time, training and supervision. y There are concerns regarding potentially sensitive content and data privacy while using digital health interventions. Measures should be taken to ensure that digitally delivered psychological interventions are provided under conditions of safety/security, confidentiality, informed consent and privacy of data. This can include the establishment of standard operating procedures that describe protocols for ensuring consent, data protection and storage, and verifying provider licensing and credentials. Further guidance can be found in the 2019 WHO guideline: recommendations on digital interventions for health system strengthening (31).

Implementation considerations y Brief psychological interventions can be delivered effectively in non-specialized health-care settings, as well as in other settings including specialized mental health care and social care. y Task sharing has been found to be an effective approach to delivering brief psychological interventions. y Integrating the provision of brief psychological interventions into primary care provides many advantages, including more holistic health care, increased accessibility of mental health services for people in need of care, opportunities for reducing the stigma of mental health problems and reduced costs. y Country adaptation and translation of training materials and tools for the provision of psychological interventions is essential. y Psychological interventions have shown to be effective for people of different ages and genders. y If all else is equal, group face-to-face interventions are less resource-intensive per person receiving care than individual face-to-face interventions. However, groups may be more difficult to organize and require an initial individual assessment for each group member and preparation of individuals for group treatment formats. In many countries, people often do not attend for health care at prespecified appointment times. Therefore, groups may experience high dropout rates or delayed session start times. y Self-help books are less cost intensive but require sufficient literacy skills, which can be limited in various settings. Materials that rely on visual or audio media may be useful alternatives. y Setting up and sustaining digital health solutions can be costly, while costs for individual users are usually not very high, making implementation feasible for the end user. y There is a need to consider the potential digital divide across population groups with some having unequal access to and skills to use digital technologies. Access might be particularly difficult for certain population groups with poor access to network services, mobile devices or electricity, and/or with low literacy and digital literacy skills. Measures should be taken to address inequities in access to mobile devices so that further inequity is not perpetuated in accessing health information and services, including mechanisms to ensure individuals who do not have access to mobile devices can still receive appropriate services.