Mental Health Web App

The ubiquity of smartphones and the development of mental health apps (MHAs) calls for evaluation of consumers' attitudes towards and usage of MHAs. Due to the increasing demand for mental health services on college campuses, research is especially needed to evaluate MHAs as a potentially viable treatment modality in that setting. The study team developed survey questions related to MHAs, added these to the Healthy Minds Study, and used Qualtrics as the platform. The participants were 741 students, age 18 and older, from a large Midwest public university. Students could answer a varying number of multiple choice questions based on embedded display logic, and the survey required 20-25 minutes for most participants to complete. Based on embedded display logic in the survey and how questions were answered, students could receive anywhere from 1-20 questions. Questions were primarily categorical (e.g., "Yes", "Maybe", "No"), with the remaining questions in free response format. The survey was fielded in April, 2016. 26.1% of respondents were open to using an MHA yet only 7.3% had used an MHA. 9.0% of respondents preferred to use an MHA versus seeing a mental health professional. 13.2% of respondents felt that MHAs do have an evidence base. 23.8% of users felt that MHAs helped with their mental health. Those who reported receiving mental health services within the past 12 months were significantly more open to using MHAs than those who had not received services. Convenience, immediate availability, and confidentiality were common reasons for interest in MHAs. There is interest in, but limited usage, of MHAs among university students, providing evidence of MHAs as a potentially untapped treatment modality for this population. Further research could help assess how best to integrate this technology into the university and college mental health system.

BackgroundMenopause presents a period of heightened vulnerability for mental health issues. Despite this, mental health screening is not consistently integrated into menopausal health care, and access to psychological interventions is limited. Digital technologies, such as web and smartphone apps, may offer a way to facilitate and improve mental health care provision throughout menopause. However, little is known about potential users’ intention to use such technologies during this critical phase of life.ObjectiveTo examine the factors that impact the intention of potential users to use a mental health app during menopause, we used the Health Belief Model (HBM), a psychological framework widely used to understand and predict individuals’ health-related behaviors.MethodsAn online survey was generated. Convenience sampling was used, with participants recruited via social media and email, through relevant foundations and support groups, and by word of mouth. Structural equation modeling with maximum likelihood estimation was conducted to explore whether the factor structure of the HBM is a good fit for predicting the intention to use a mental health app for menopause. A Cronbach α value of .05 was used for determining statistical significance.ResultsA total of 1154 participants commenced the survey, of which 82.49% (n=952) completed at least 97% of the survey. Of these, 86.76% (n=826) expressed that their menopausal symptoms had negatively affected their mental health, and went on to answer questions regarding their experiences and interest in using a web or smartphone app for mental health symptoms related to menopause. Data from this subgroup (N=826) were analyzed. In total, 74.09% (n=612) of respondents sought online help for mental health symptoms related to menopause. The most common topics searched for were symptom characteristics (n=435, 52.66%) and treatment or therapy options (n=210, 25.42%). Psychoeducation (n=514, 62.23%) was the most desired mental health app feature, followed by symptom tracking (n=499, 60.41%) and self-help tips (n=469, 56.78%). In terms of the intention to use a mental health app, the Satorra-Bentler–scaled fit statistics indicated a good fit for the model (χ2278=790.44, P<.001; comparative fit index=0.933, root mean square error of approximation=0.047, standardized root mean square residual=0.056), with cues to action emerging as the most significant predictor of intention (β=.48, P<.001). This was followed by perceived barriers (β=–.25, P<.001), perceived susceptibility (β=.15, P<.001), and perceived benefits (β=.13, P<.001). Perceived severity (β=.01, P=.869) and self-efficacy (β=.03, P=.286) were not significantly associated with behavioral intention.ConclusionsThis study reveals important factors that influence the intention to use a mental health app during menopause. It emphasizes the need to address barriers to app usage, while highlighting the impact of credible endorsements and psychoeducation. Furthermore, the study underscores the significance of improving accessibility for users with lower digital literacy or limited resources.

There has been a surge in mental health apps over the past few years. While these have great potential to address the unmet mental health needs of the population, the recent proliferation of mental health apps in the commercial marketplace has raised several concerns, such as privacy, evidence-based, and quality. Although there is mounting research on the effectiveness of mental health apps, the majority of these are not accessible to the public and most of those available have not been researched. Despite the rapid growth of the digital health market in India, there are no comprehensive reviews of publicly available mental health apps for Indian users. Hence it becomes important to review mental health apps freely available to potential end users in terms of their scope, functions, and quality. This study aims to systematically evaluate mental health apps available to Indian users in app stores. This systematic review of mental health apps will be performed following the Target user, Evaluation focus, Connectedness and Health domain approach and the PASSR (Protocol for App Store Systematic Reviews) checklist. Fifteen key search terms covering various mental health conditions and therapies will be used on the Android and iOS stores. The identified apps will be further screened and reviewed based on the inclusion and exclusion criteria. The pool of eligible apps will be downloaded for detailed review. The following steps will be adopted to streamline the review process and interrater consistency. Six apps will be randomly selected from the downloaded apps, for joint discussion and review by a team of 4 primary reviewers and 2 mentors. Following this, a new set of 6 randomly selected apps will be rated independently by the primary reviewers and the differences in ratings will be jointly discussed for generating consensus. Subsequently, the primary reviewers will individually review the remaining apps in the list. Data will be extracted based on predecided parameters such as privacy policy, basic purpose, type of developer, nature of intervention strategies, and guided versus unguided nature. Additionally, the apps will be reviewed for quality using the Mobile Application Rating Scale. The data analysis and synthesis strategy will incorporate descriptive statistics based on quality evaluation using the Mobile Application Rating Scale and examining the content of the apps for generating descriptive information. The initial screening of mental health apps available for Indian users on the Google Play Store and Apple App Store was initiated in October 2024. We expect to complete the detailed systematic review by April 2025. This study will offer a comprehensive review of mental health apps available in digital marketplaces for Indian users and has implications for end users, policy makers, developers, and mental health professionals. International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY2024100035; https://inplasy.com/inplasy-2024-10-0035/. DERR1-10.2196/71071.

Predicting determinants influencing user satisfaction with mental health app: An explainable machine learning approach based on unstructured data

This letter builds upon McCarthy and Horwitz’s study published in Journal of American College Health, which examined first-year college students’ attitudes and barriers to mental health apps. The letter highlights key areas for further research, including considering the role of international student status in mental health app use, incorporating pharmacological treatment history into mental health treatment measures, and expanding the application of the Health Belief Model to capture additional constructs pertinent to college students’ attitudes toward mental health apps. It advocates for longitudinal studies to assess causal relationships between prior mental health care use and mental health app engagement. Finally, the letter proposes utilizing the Consolidated Framework for Implementation Research to explore the multi-level factors influencing attitudes toward and use of mental health apps among college students. Insights provided in this letter have the potential to inform strategies to expand the reach of mental health apps among college students.

Background: Integrating behavioral health (BH) services into primary care is an evidence-based intervention that can increase access to care, improve patient outcomes, and decrease costs. Digital technology, including smartphone apps, has the potential to augment and extend the reach of these integrated behavioral health services through self-management support impacting lifestyle behaviors. To date, the feasibility and acceptability of using mental health mobile apps within an integrated primary care setting has not yet been explored as part of routine clinical care.Objectives: The objectives of this study were to (a) test the feasibility of using mental health applications to augment integrated primary care services; (b) solicit feedback from patients and providers to guide implementation, and (c) develop a mental health apps toolkit for system-wide dissemination.Methods: Cambridge Health Alliance (CHA) is a safety-net healthcare system that includes three community hospitals and 12 Primary Care (PC) clinics serving nearly 150,000 ethnically and socioeconomically diverse patients around Boston. To select and disseminate mental health apps, a four-phase implementation was undertaken: (1) Evaluation of mental health mobile applications (2) Development of an apps toolkit with stakeholder input, (3) Conducting initial pilot at six primary care locations, and (4) Rolling out the app toolkit across 12 primary care sites and conducting 1-year follow-up survey.Results: Among BH providers, 24 (75%) responded to the follow-up survey and 19 (83%) indicated they use apps as part of their clinical care. Anxiety was the most common condition for which app use was recommended by providers, and 10 (42%) expressed interest in further developing their knowledge of mental health apps. Among patients, 35 (65%) of participants provided feedback; 23 (66%) reported the tools to be helpful, especially for managing stress and anxiety.Conclusions: Our findings indicate mental health apps are applicable and relevant to patients within integrated primary care settings in safety-net health systems. Behavioral health providers perceive the clinical value of using these tools as part of patient care, but require training to increase their comfort-level and confidence applying these tools with patients. To increase provider and patient engagement, mobile apps must be accessible, simple, intuitive and directly relevant to patients' treatment needs.

How private is your mental health app data? An empirical study of mental health app privacy policies and practices

Apps are an increasingly commonplace source of support and authority for managing mental (ill)health symptoms. This article analyses their increasingly agential role in support practices through their capacity to reconfigure individual and collective understandings of mental health. New materialist research acknowledges the agency of both human and non-human actors and considers the on-going relations of bodies and technology within social contexts. We apply the concept of digital atmosphere to trace the material-affective forces constituting the experience of using a mental health app. Our findings demonstrate the multiplicity of ways people improvise with their use, situated within their own unique contexts and environments, and the influence of relationships on individual perceptions and engagements with the apps. Furthermore, we consider the different ways in which participants perceive their mental (ill)health, sometimes in fractious conflict with the apps. Finally, we highlight that features of for-profit apps can reshape understanding of mental (ill)health needs and perceptions of responsibility, resulting in the capacity for apps to be simultaneously disciplining and liberating. The findings provide insight of significant value to mental health policy and practice.

FDA’s Streamlined Health App Approval: Better for Patients or Companies?

BackgroundMental and emotional self-help apps have emerged as potential mental illness prevention and treatment tools. The health behavior theory mechanisms by which these apps influence mental health–related behavior change have not been thoroughly examined.ObjectiveThe objective of this study was to examine the association between theoretical behavior change mechanisms and use of mental and emotional self-help apps and whether the use of such apps is associated with mental health behaviors.MethodsThis study utilized a cross-sectional survey of 150 users of mental or emotional health apps in the past 6 months. Survey questions included theory-based items, app engagement and likeability items, and behavior change items. Stata version 14 was used to calculate all statistics. Descriptive statistics were calculated for each of the demographic, theory, engagement, and behavior variables. Multiple regression analysis was used to identify factors associated with reported changes in theory and separately for reported changes in actual behavior after controlling for potentially confounding variables.ResultsParticipants reported that app use increased their motivation, desire to set goals, confidence, control, and intentions to be mentally and emotionally healthy. Engagement (P<.001) was positively associated with the reported changes in theory items, whereas perceived behavior change was positively associated with theory (P<.001), engagement (P=.004), frequency of use of apps (P=.01), and income (P=.049).ConclusionsParticipants reported that app use increased their motivation, desire to set goals, confidence, control, and intentions to be mentally and emotionally healthy. This increase in perceptions, beliefs, and attitudes surrounding their mental and emotional health was considerably associated with perceived change in behavior. There was a positive association between the level of engagement with the app and the impact on theory items. Future efforts should consider the value of impacting key theoretical constructs when designing mental and emotional health apps. As apps are evaluated and additional theory-based apps are created, cost-effective self-help apps may become common preventative and treatment tools in the mental health field.

HighlightsWhat are the main findings?68.9% were aware of smartphone mental health apps, but only 20% of them made use of them, highlighting the significant awareness–use gap.Female and young adults (18–24 years) demonstrated increased awareness and use.Acceptance was predicted best by the performance expectancy, and the privacy concern did not significantly affect it.What are the implications of the main findings?The gap between awareness and utilization highlights the need for promoting active use of mental health interventions.App usability and user experience must be optimized by the developers to create broader acceptance.Findings are in support of integrating digital mental health tools into Saudi Vision 2030 strategies of accessible, patient-centered care.Background: Mental health is increasingly prioritized in Saudi Arabia, with growing interest in digital solutions. Objectives: The study’s objective was to assess awareness, acceptance, and use of mobile mental health applications among Saudis. Methods: A cross-sectional online survey, based on the UTAUT model, explored performance expectancy, effort expectancy, social influence, and privacy concerns among 1613 participants. Results: While 68.9% were aware of at least one mental health app, only 20% actively used them. Awareness was influenced by gender, age, employment, marital status, and region, whereas utilization depended on gender, age, education, region, and acceptance. Performance expectancy strongly predicted usage. Conclusions: Despite high awareness, usage of mobile mental health applications remains low in Saudi Arabia. Demographic factors affect awareness, and acceptance drives utilization. App developers should consider these factors to enhance engagement and effectiveness.

This paper aims to objectively compare the use of mental health apps between the pre-COVID-19 and during COVID-19 periods and to study differences amongst the users of these apps based on age and gender. The study utilizes a dataset collected through a smartphone app that objectively records the users’ sessions. The dataset was analyzed to identify users of mental health apps (38 users of mental health apps pre-COVID-19 and 81 users during COVID-19) and to calculate the following usage metrics; the daily average use time, the average session time, the average number of launches, and the number of usage days. The mental health apps were classified into two categories: guidance-based and tracking-based apps. The results include the increased number of users of mental health apps during the COVID-19 period as compared to pre-COVID-19. Adults (aged 24 and above), compared to emerging adults (aged 15–24 years), were found to have a higher usage of overall mental health apps and guidance-based mental health apps. Furthermore, during the COVID-19 pandemic, males were found to be more likely to launch overall mental health apps and guidance-based mental health apps compared to females. The findings from this paper suggest that despite the increased usage of mental health apps amongst males and adults, user engagement with mental health apps remained minimal. This suggests the need for these apps to work towards improved user engagement and retention.

BackgroundUser experience and engagement are critical elements of mental health apps’ abilities to support users. However, work examining the relationships among user experience, engagement, and popularity has been limited. Understanding how user experience relates to engagement with and popularity of mental health apps can demonstrate the relationship between subjective and objective measures of app use. In turn, this may inform efforts to develop more effective and appealing mental health apps and ensure that they reach wide audiences.ObjectiveWe aimed to examine the relationship among subjective measures of user experience, objective measures of popularity, and engagement in mental health apps.MethodsWe conducted a preregistered secondary data analysis in a sample of 56 mental health apps. To measure user experience, we used expert ratings on the Mobile App Rating Scale (MARS) and consumer ratings from the Apple App Store and Google Play. To measure engagement, we acquired estimates of monthly active users (MAU) and user retention. To measure app popularity, we used download count, total app revenue, and MAU again.ResultsMARS total score was moderately positively correlated with app-level revenue (Kendall rank [T]=0.30, P=.002), MAU (T=0.39, P<.001), and downloads (T=0.41, P<.001). However, the MARS total score and each of its subscales (Engagement, Functionality, Aesthetics, and Information) showed extremely small correlations with user retention 1, 7, and 30 days after downloading. Furthermore, the total MARS score only correlated with app store rating at T=0.12, which, at P=.20, did not meet our threshold for significance.ConclusionsMore popular mental health apps receive better ratings of user experience than less popular ones. However, user experience does not predict sustained engagement with mental health apps. Thus, mental health app developers and evaluators need to better understand user experience and engagement, as well as to define sustained engagement, what leads to it, and how to create products that achieve it. This understanding might be supported by better collaboration between industry and academic teams to advance a science of engagement.

Given the substantial investment in the development of mental health mobile applications (apps), information about penetration in the patient populations of interest is critical. This study describes the proportion of veterans who are knowledgeable of and utilize the Department of Veteran Affairs (VA) and Department of Defense (DoD) mental health apps. A cross-sectional survey of 140 veterans was conducted in primary care and outpatient mental health clinics at a large VA facility. Ninety-one percent of veterans (n = 127) reported smartphone ownership. Of these, 42.5% and 20.4% had heard of and used at least one of the 22 VA/DoD mental health apps, respectively. When veterans were asked to pick the individual VA/DoD apps they had previously used from a list, the proportion of participants who reported prior use ranged from 0% (Moving Forward) to 6.5% (Mindfulness Coach). Treatment for psychiatric problems relevant to the apps did not predict veteran knowledge/use of the VA/DoD apps. Rates of app use remained low among veterans reporting symptoms/diagnoses apps were designed to address (e.g., 7.5% of veterans who reported posttraumatic stress disorder (PTSD) had used PTSD Coach). The most common barrier to app use (endorsed by 65.7% of participants) was awareness of the apps. Expansion of existing VA/DoD efforts to educate patients and providers treating relevant conditions is indicated. Evaluation of evidence-based mobile health support specialists in clinical settings may also be indicated. This study provides critical information to guide future dissemination efforts and to help evaluate the impact of investments to date. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The aim of the paper is to establish the requirements and methodology for the development and implementation of a recommender system for mental health apps to support patients in self-managing their mental health while awaiting formal treatment. The system was developed using an algorithm-based approach, including: (1) user needs assessment through literature review and interviews with various stakeholders, (2) software modelling and prototype creation, and (3) bench testing of the prototype with health experts and users. Based on initial exploration of users' requirements, relevant standards and regulations, a library of trusted mental health apps was compiled and a recommendation engine was built to generate accurate user profiles and deliver personalised health recommendations, which will be further tested to ensure quality. Developing a constructive mental health recommendation system requires the establishment of clear and comprehensive requirements, as well as a robust methodology adressing concerns related to data security, confidentiality, safety, and reliability. Subsequent research may compare various indicators of mental health outcomes at the start and end of patients' waiting period to gain more insights into how the recommender system could be further improved to enhance user experience and their overall well-being.