WHO, in collaboration with the Pan American Health Organization (PAHO) and Lebanon’s National Mental Health Programme, showcased Step-by-Step at the World Bank Group’s biennial Fragility Forum in Washington, DC. The forum convened more than 1500 representatives from governments, international organizations and civil society to advance the development agenda in the world’s most fragile and crisis-affected communities. WHO was invited to demonstrate Step-by-Step – a digital self-help intervention for depression, alongside innovations presented by Stanford University and Google. The World Bank Group selected Step-by-Step from among more than 50 innovations that they reviewed in the lead up to the Forum.
About Step-by-Step
Step-by-Step is a free digital tool developed by WHO in collaboration with Lebanon’s National Mental Health Programme and other partners, that helps people manage depression and anxiety on their own, with light guidance from a trained supporter. It uses a picture-based story to walk users through evidence-based techniques for managing common mental health conditions. Users complete five modules, with weekly contacts – of around 15 minutes each – from a trained non-specialist helper, such as a community health worker.
Evidence-based
Clinical trials in Lebanon involving nearly 1250 participants – including 680 Lebanese participants and 569 Syrian participants – showed that Step-by-Step significantly reduced depression, anxiety and stress, and improved daily functioning. By the end of the programme, a reduction in depressive symptoms of more than 50% was reported by almost half (46%) of Lebanese participants and more than one third (37%) of Syrian participants compared to approximately 14% of those who did not use the programme. Cost-effectiveness analyses further suggest that Step-by-Step may offer a cost-saving response to depression in humanitarian emergencies in low- and middle-income countries.
Used globally
Step-by-Step is already in use nationwide in Lebanon and Thailand, as part of each country’s mental health system. In India, the NGO – Kaya Guides – has adapted Step-by-Step for delivery through a widely used messaging app. Together, these programmes have provided thousands of people with evidence-based support for depression. The content is freely available from the WHO website for any organization or country to adapt for their own context.
A new implementation guide
The Fragility Forum coincided with the recent launch of WHO’s new practical guide: Psychological self-help interventions: delivering self-help for individuals, featuring Step-by-Step and Doing What Matters in Times of Stress (WHO, 2026). The guide is designed to help governments, health workers, organizations and planners bring evidence-based mental health support to more people, particularly in low-resource and crisis-affected settings.