For psychologists and psychiatrists in South Africa

What happens between sessions shouldn't be a guess.

Hope is a patient app in early design. It helps people keep a simple record of mood, medication and sleep between appointments, and turns that record into a one-page summary they can bring to you.

Before any of it is built, I'm asking clinicians what would actually be useful in the room.

A goodwill project. Free for patients and free for practitioners.

Since your last appointment
Sample data
PHQ-9, fortnightly
16 → 9
score of 10 16 15 12 13 9
Doses logged as taken
21 of 28
Five of the missed doses fall in week 3
Sleep, from phone
5 h 40
Week 3 average. Other weeks near 7 h
Days with a check-in
Gaps are shown, never filled in
Patient's notes for this session
“Nausea in the first week, gone now. Bad stretch after the retrenchment news. Want to ask about sleep.”
Illustrative only. What belongs on this page is the main thing I want to learn from you.
The problem

A follow-up is fifteen minutes. Much of it goes to reconstructing the last six weeks.

Recall is weakest where it matters

People remember the last few days and the worst day. The weeks in between, and whether things were slowly getting better or worse, are mostly gone by the time they sit down.

Adherence is hard to ask about

Someone who skipped or stopped a medication often won't say so unless asked directly. The first weeks on a new prescription are when it quietly happens, and when a script runs out before the next appointment.

Measurement takes time nobody has

Routine use of validated measures such as the PHQ-9 and GAD-7 is well supported. On paper they need handing out, scoring and filing, so in a busy practice it mostly doesn't happen.

What your patient gets

A small, private tool that asks for five seconds a day.

Most mental health apps are abandoned within weeks, and people log least when they're doing worst. So everything here either takes seconds or is useful without daily input.

01

A five-second check-in

One tap for mood. Sleep and activity come from the phone where the person allows it, so there's less to type.

02

Medication reminders and a refill countdown

Dose reminders that work with no connection, and a warning days before a script runs out. Running out is the most avoidable reason people stop abruptly.

03

A personal safety plan

Written while well, ideally with you: their own warning signs, what helps, who to call. Kept on the phone, one tap from anywhere in the app.

04

Crisis help that works offline

South African helplines, verified directly with each organisation, reachable in one tap with no data or signal to the app's servers needed.

05

The process, explained

Psychologist, psychiatrist or counsellor. What a first session is like. What medical aids must cover, how the public route works, and lower-cost options. Written or reviewed by a registered clinician before anything is published.

06

Session capture

A running list of things to raise next time, and a prompt afterwards for what was agreed. People go blank in the room and forget on the drive home.

07

Discretion

Biometric lock, a neutral name and icon, and reminders that never name a medication on the lock screen. Phones get shared and stigma is real.

08

Built for local conditions

Fully usable offline, a small download, and planned in Afrikaans, isiZulu and Sesotho as well as English, using only official translations of any questionnaire.

What you get

The between-session layer. Not another system to run.

Hope doesn't replace your practice software or your notes. It covers the gap between appointments and hands you the result in a form you can read in under a minute.

A one-page summary

Mood trend, questionnaire scores, doses taken and missed, sleep, and the patient's own notes since you last saw them. Shared only when the patient chooses to, as a PDF or through a simple web view.

Questionnaires before the session

Ask for a PHQ-9 or GAD-7 to be completed ahead of an appointment. You see item-level answers and the trend over time, with no paper and no scoring.

Intake before the first visit

History, consent and telehealth consent completed at home, so the first session starts with the person and not the clipboard.

Fewer missed appointments

Appointment reminders on the patient's phone, alongside the reminders they already rely on for medication.

If you're a psychologist

Between-session work that actually comes back

Thought records, behavioural activation logs and sleep diaries, completed in the app during the week and visible to you before the session, not reconstructed in the waiting room.

If you're a psychiatrist

A clear view of the titration weeks

Doses and side effects logged daily through the first weeks on a new medication, which is when people are most likely to stop without telling anyone.

Later, not first

A directory that tells the truth about availability

Every listed practitioner verified against the HPCSA register, with a simple "accepting new patients" flag so people stop phoning ten practices to hear about a three-month wait. No referral commissions and no fee-sharing, in line with the HPCSA's ethical rules.

What it costs

Free for patients. Free for practitioners.

Hope is a goodwill project. Everything described on this page, on the patient side and on yours, will be free to use.

Why free

Cost is already the biggest barrier to mental health care here. An app that helps people get to care, and stay in it, shouldn't add another one.

If it grows

If Hope grows into something larger, additional features may be paid. They would be extras, clearly marked. What's described on this page stays free.

Not paid for with data

Free doesn't mean the patient is the product. No advertising, and no selling or sharing of anyone's data to fund it.

What Hope will not do

The limits are part of the design.

An app in this space can do harm by trying to be helpful. These are decisions, not omissions.

It will not diagnose or interpret

It shows a score and the standard range that score falls in. It never tells a patient what they have, or what to change.

No AI therapist

No chatbot stands in for a clinician. A poor reply to someone in crisis is not a risk worth taking.

No automatic alerts to family

Most alerts triggered by a screening score would be false alarms, and one false alarm teaches a person to stop answering honestly. A trusted contact they can call in one tap, yes. Surveillance, no.

No streaks, badges or rewards

A broken streak punishes someone at exactly their lowest point.

No peer forum

Peer spaces need round-the-clock moderation to be safe. That can't be done responsibly here, so it won't be done.

No prescribing, no interaction checker

Prescriptions and medication decisions stay with you and the pharmacist. The app records what was taken and nothing more.

Not your record system

Your clinical notes, billing and medical aid claims stay where they are. Hope holds the patient's own record, not yours.

Not a monitored service

Nobody watches the data in real time, and the app says so plainly to the patient. It points to help. It doesn't pretend to be help.

Safety and data

Decisions already made, open to your challenge.

Item 9 is never just a number

Any answer other than "not at all" to the PHQ-9 self-harm item opens the crisis screen and the person's own safety plan immediately, on the device, with no network involved.

The crisis screen can't break

Helpline numbers ship inside the app, each with a named owner and a date it was last confirmed with the organisation. A dead number there is the worst bug the app could have.

The patient owns the record

Sharing is explicit, per clinician, and can be withdrawn. Health data is special personal information under POPIA and is treated that way from the first line of code.

Encrypted at both ends

The record is encrypted on the phone and again on the server, with keys held separately from the data. The app works in full with no account and no connection.

Validated instruments, official wording

PHQ-9 and GAD-7 to start, asked no more often than their two-week window allows, in their official translations only. Which instruments and cut-offs suit local practice is a question for you.

Honest charts

Missing days are shown as missing, because silence is information. No monthly averages over partial data, and no computed claims about what is causing what.

Where this stands

I need thirty minutes of your scepticism.

Hope is in early design. Nothing on this page is built in a way that can't change, and I'd rather hear that an idea is wrong now than after it ships. In a short call or over coffee, I'd like to ask you four things.

  1. 01
    What do you wish you knew when a patient walks in for a follow-up?
  2. 02
    What would make you distrust a summary your patient generated?
  3. 03
    Which of the features on this page would you use, and which would you ignore?
  4. 04
    What's missing that you'd want your patients to have?
Short on time?
Answer the four-minute questionnaire instead
Who's asking
Zandré Schalkwyk
Senior software engineer, 10x.cafe
Pretoria and Johannesburg

I'm an engineer, not a clinician. That is exactly why this page exists: the clinical decisions in this app should be made by people qualified to make them.

Also looking for a clinical advisor

A registered psychologist or psychiatrist to review the instruments, the patient-facing content and the crisis flow.

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