Mental Health and Digital Therapy Apps as Void Objects: Clinical Opacity, Engagement Architecture, and Documented Harm — A Within-Domain Spearman Convergence

Key Points

• Evaluate the clinical opacity and engagement architecture of digital mental health apps and their association with documented harm.
• Analyzed twelve digital mental health platforms including BetterHelp and Talkspace.
• Scored platforms on algorithm transparency, personalized content, and subscription dependency.
• Calculated Spearman correlation between platform scores and documented harm from various sources.
• Found significant correlation between lower algorithm transparency and higher documented harm.
• Identified specific areas where platforms fail in crisis response and data portability.
• Noted the prevalence of therapist relationship lock-in affecting user engagement.

Abstract