Digital Use of Standardized Assessment Tools: Copyright & Licensing

MHIRA relevance

Centralized repository of freely available instruments with clear digital licensing
Permissions tracking and multilingual instrument support for diverse settings
LMIC‑friendly deployment and de‑identified data export for collaborative research

Mental Health Service Gap in LMICs

Approximately 10% of children and adolescents in low- and middle-income countries (LMICs) experience mental health disorders, yet the vast majority lack access to evidence-based assessment and treatment. This treatment gap reflects multiple barriers including limited mental health infrastructure, workforce shortages, and restricted access to validated assessment instruments.

Licensing fees and copyright restrictions for standardized assessment tools create additional barriers to implementation in resource-constrained settings, where per-capita health expenditure may be insufficient to support proprietary instrument costs.

Systematic Review Methodology

This study conducted a systematic examination of copyright and licensing terms for 109 standardized mental health assessment instruments for children and adolescents. The review expanded upon prior work to include personality disorder assessment tools and explicitly evaluated digital implementation feasibility.

For each instrument, researchers contacted authors and publishers to clarify copyright status, licensing requirements, and permissions for digital administration. This process revealed significant challenges including unclear copyright information, difficulty contacting rights holders, and variability in licensing terms across instruments.

Key Findings

The systematic review identified 53 instruments (49% of total) available for free digital use across 11 mental health domains, including:

Depression and anxiety disorders
Behavioral and conduct problems
Attention-deficit/hyperactivity disorder
Post-traumatic stress disorder
Autism spectrum disorders
Personality pathology

However, copyright ambiguity, lack of clear licensing terms, and difficulty contacting rights holders created substantial barriers to determining digital implementation permissions for many instruments.

Implications for Digital Implementation

Digital administration of standardized instruments offers multiple advantages for LMICs: reduced costs through elimination of printing and physical distribution, automated scoring reducing clinician burden, improved data quality through structured data capture, and facilitation of longitudinal monitoring.

The identification of 53 freely available instruments provides a foundation for digital mental health platforms targeting resource-constrained settings. However, the copyright complexity encountered highlights the need for improved transparency in licensing terms and streamlined processes for obtaining digital implementation permissions.

Need for Centralized Repositories

The study findings underscore the critical need for comprehensive online repositories of freely available clinical instruments with clear licensing information. Such infrastructure would reduce redundant efforts by clinicians and researchers seeking to identify suitable assessment tools and clarify implementation permissions.

Digital platforms like MHIRA address this gap by providing centralized access to validated instruments with appropriate permissions, supporting systematic evidence-based assessment implementation in diverse clinical and research contexts.

Authors: Marianne Cottin, Kathrin Blum, Jon Konjufca, Yamil Quevedo, Sylvia Kaaya, Alex Behn, Klaus Schmeck, Carla Sharp, and Ronan Zimmermann

Read Full Article on BMC Psychiatry

Digital Use of Standardized Assessment Tools: Copyright and Licensing Analysis for Low- and Middle-Income Countries