Innovating mental healthcare with blockchain technology: Expert perspectives from Tanzania

This study examines expert perceptions of the potential role of blockchain technology in mental healthcare in Tanzania, focusing on perceived applications, implementation barriers, ethical and regulatory considerations, and anticipated impacts on patient empowerment, research, and professional–patient relationships. A three-round Delphi method was employed, involving 45 experts with backgrounds in mental health, blockchain, health informatics, and public sector governance. Data were collected using structured questionnaires and analysed using descriptive statistics, Kendall’s coefficient of concordance, Wilcoxon signed-rank tests to assess stability across rounds, and thematic analysis of open-ended responses. Experts perceived secure electronic health record management, patient identity verification, and clinical trial data integrity as the most promising application areas. However, a strong consensus also emerged around significant barriers, particularly high implementation costs, limited technical capacity, regulatory uncertainty, and infrastructural constraints. Ethical concerns were not limited to privacy and data ownership but also reflected tensions between immutable data storage and fluctuating decisional capacity in mental health contexts. Patient empowerment was primarily associated with greater control over data access and improved transparency, though some experts questioned whether vulnerable populations could effectively assume these responsibilities without institutional support. The findings reflect informed expectations rather than empirical evidence of technical or economic feasibility. While experts anticipate that blockchain could strengthen data governance and trust in mental health systems, successful adoption in low-resource settings is likely to depend on foundational investments in digital infrastructure, workforce capacity, regulatory clarity, and participatory governance. The study provides context-specific insights to inform policy dialogue and future empirical evaluations of digital health innovations in mental healthcare.