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 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.