Insights from user reviews to improve mental health apps
Open accessAbstract
Mental health applications hold great promise as interventions for addressing common mental issues. Although many people with mental health issues use mobile app interventions, their adherence level remains low. Low engagement affects the effectiveness of mobile interventions. However, there is still a dearth of research to explain the reasons for low engagement. User experience and usability are two factors that determine the adoption and usage of apps. Analyzing user reviews of mobile apps for mental health issues reveals user experience and what features users liked and disliked in the apps and hence informs future app design and refinements. This research aims to analyze user reviews of publicly available mental health applications to uncover their strengths, weaknesses, and gaps, hence revealing why users are likely to cease using these applications. We mined reviews of 106 mental health apps retrieved from Apple’s App Store and Google Play and employed thematic analysis on 13,549 reviews. The review analysis shows that users placed more emphasis on the user interface and the user-friendliness of the app. Users also appreciated apps that present them with a variety of options, functionalities, and content that they can choose. Again, apps that offer adaptive functionalities that allow users to adapt some app features also received high ratings. In contrast, poor usability emerged as the most common reason for abandoning mental health apps. Other pitfalls include lack of a content variety, lack of personalization, lack of customer service and trust, and security and privacy issues.
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Poor usability is the most common reason for abandoning mental health apps.
“Conversely, poor usability has emerged as the most common reason for abandoning mental health apps [39].”
Some independent research studies observed that often there is poor engagement from patients in continuing to use mental health apps after a few attempts.
“Some independent research studies observed that often there is poor engagement from patients in continuing to use the apps after a few attempts [1];”
From A conversational artificial intelligence agent for a mental health care app: Evaluation study of its participatory design (2021) · cites this paper as [1]
DMHIs allow people to access psychotherapy skills and content in their own time and empower them to self-manage their symptoms.
“DMHIs allow people to access psychotherapy skills and content in their own time and empower them to self-manage their symptoms [7-11].”
Many existing self-guided and guided DMHIs include linear, one-size-fits-all programs that cannot be individually tailored, which negatively affects user engagement and is a barrier for mental health professionals.
“Many existing self-guided and guided DMHIs include linear, one-size-fits-all programs for a specific disorder (eg, major depressive disorder) or multiple disorders (eg, transdiagnostic programs for mixed anxiety or anxiety and depression).”
Several factors contribute to low DMHI engagement, including technical issues, motivation issues, and a lack of user-driven design.
“Several factors contribute to low DMHI engagement, including technical issues, motivation issues, and a lack of user-driven design [11,25,31,32].”
These findings are consistent with DMHI research conducted before, during, and after the COVID-19 pandemic [11,31,47,62], indicating these 3 factors should be considered in the design of DMHIs for depression and anxiety.
“These findings are consistent with DMHI research conducted before, during, and after the COVID-19 pandemic [11,31,47,62], indicating these 3 factors should be considered in the design of DMHIs for depression and anxiety.”
Past research has found that the esthetic qualities of DMHI design are linked to better usability and user-friendliness [11,62].
“This is an important consideration given that past research has found that the esthetic qualities of DMHI design are linked to better usability and user-friendliness [11,62].”
In qualitative interviews, participants emphasized that a DMHI should be backed by scientific research and developed by a reputable organization, consistent with previous research that showed that inadequate information about credibility can affect user trust in a DMHI [11].
“In qualitative interviews, participants emphasized that a DMHI should be backed by scientific research and developed by a reputable organization, consistent with previous research that showed that inadequate information about credibility can affect user trust in a DMHI [11].”
Consistent with previous research [11,31,62], participants wanted to personalize a DMHI to suit their needs and set goals.
“Consistent with previous research [11,31,62], participants wanted to personalize a DMHI to suit their needs and set goals.”
A lack of DMHI personalization is a common barrier to user engagement [25] and a common source of user dissatisfaction [11].
“These findings are especially important, given that a lack of DMHI personalization is a common barrier to user engagement [25] and a common source of user dissatisfaction [11].”
Features that support social connectedness were also desired as an inclusion in past DMHIs [11,25].
“Features that support social connectedness were also desired as an inclusion in past DMHIs [11,25], and the need for isolation during the COVID-19 pandemic may have exacerbated this need.”
This corresponds with existing research indicating that many studies have found that participants prefer free DMHIs [11].
“This corresponds with existing research indicating that many studies have found that participants prefer free DMHIs [11], highlighting the need for future DMHIs to be accessed free of charge or at a low cost.”
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- Authors
- Alqahtani, F., & Orji, R.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Alqahtani, Felwah
- Venue
- Health Informatics Journal
- Publisher
- SAGE Publications
- Published
- 2020-01-10
- Volume
- 26
- Issue
- 3
- Pages
- 2042-2066
- ISSN
- 1355-4743 (ISSN-L)
- 1460-4582
- 1741-2811
- OpenAlex
- W2999181723
- Cited by
- 286
- References
- 27
- Citations by year
- 2026: 38 · 2025: 62 · 2024: 62 · 2023: 50 · 2022: 39 · 2021: 29 · 2020: 6
- FWCI
- 27.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Health Informatics Journal (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- natural sciences and engineering research council of canada
- king khalid university
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
- Keywords
- mental health apps, online reviews, app abandonment, user engagement, usability, user experience, mobile health intervention, mobile application design, adaptive traits, personalization, privacy and security, customer service
- MeSH terms
- Humans, Mental Health, Privacy, Mobile Applications
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