Exploring the impact of mental health-related mobile applications on people with a lived experience of mental illness (Preprint)

BACKGROUND Mental health apps are widely promoted to support assessment, self-management, and recovery. Yet their real-world value for people with lived experience depends on how apps are encountered, trusted, and sustained (or abandoned) in everyday life—contexts that quantitative trials alone rarely capture. OBJECTIVE To synthesize qualitative evidence on how individuals with lived experience of mental illness use mental health–related mobile apps and to develop a line-of-argument model explaining variability in engagement, perceived benefit, and burden across settings. METHODS We conducted a qualitative evidence synthesis using meta-ethnography (Noblit & Hare) and reported per eMERGe guidance. We searched CINAHL for English-language qualitative studies on mental health app use (2019–2024) and complemented this with backward/forward citation checking. Two reviewers independently screened records, extracted first-order (participant) and second-order (author) constructs, and appraised study quality using NICE qualitative standards. Through reciprocal translation and synthesis of translations, we generated third-order interpretations and an integrative line-of-argument. RESULTS Six studies from the United States, England, and the Netherlands were included, spanning apps targeting depression/anxiety, bipolar disorder, serious mental illness, and suicide prevention. Four cross-cutting themes emerged. (1) Apps as adjuncts, not replacements: they scaffold self-regulation between clinical contacts but are often set aside during crises. (2) Self-management and empowerment: mood/symptom tracking, prompts, and psychoeducation can strengthen insight and agency when tailored and meaningful. (3) Privacy, data governance, and trust: opaque data flows, surveillance concerns, and uncertainty about escalation pathways constrain disclosure and sustained use. (4) Design, usability, and discontinuation: low cognitive load, reliability, and personalization facilitate integration into routines; glitches, advertising, and burdensome data entry drive attrition. These dynamics shaped whether app use translated into improved day-to-day functioning and therapeutic conversations. CONCLUSIONS Mental health apps can extend person-centered care when embedded within trusted therapeutic relationships and usable ecosystems. Implementation should prioritize co-design with people with lived experience, transparent and choice-rich data governance (eg, clear data routes, consent options, and review plans), and design choices that minimize cognitive load—especially during distress. Clinicians and services should agree on what to track, how to review app data, and when to escalate, treating apps as shared tools rather than stand-alone solutions. Further work should standardize reporting of privacy practices and engagement trajectories and evaluate models that integrate app data into routine care without increasing burden for users or clinicians.