The Quality and Characteristics of Digital Mental Health Apps: Mixed Methods Study

Abstract Background There are around 20,000 mental health apps available in app stores. The Organisation for the Review of Care and Health Apps (ORCHA), a United Kingdom digital health compliance company, has assessed a number of digital mental health apps with regard to their quality, professional and clinical assurance, data privacy, and user experience. This study analyzes the data that were collected by ORCHA when they assessed mental health apps. Objective This study aimed to examine the characteristics of mental health apps regarding their quality, target users, features, underpinning evidence, and data privacy. Methods A dataset comprising ORCHA Baseline Review assessments of over 2000 digital health apps, including 436 mental health apps, was used. This study uses exploratory data analysis to gain insight into the quality and characteristics of mental health apps. Methods such as descriptive and inferential statistics, k-modes clustering, and association rule mining were used to explore the quality of mental health apps as well as reveal insights into the different cost types, target users, app features, data types, and evidence of app content. Results Information provision, data capture, and data sharing were the most common features within the 436 mental health apps. The examined apps primarily targeted the following groups: adults (n=229, 52.5%), everyone (n=184, 42.2%), and teens (n=135, 31%). The cost of apps has not been linked to the quality of mental health apps, although paid apps or apps with in-app purchases may include additional services. Indicated user acceptance or benefit is the most common type of evidence provided by these mental health apps. A total of 241 (55.3%) apps included a qualified professional in app development, and 251 (57.6%) apps provided evidence within the app that the developer validated any guidance with relevant reliable information sources or references. Usage data and email were the most commonly collected data types. Association rule mining showed that email, IP address, name, and usage data are often co-collected by the same apps. K-modes cluster analysis showed that mental health apps can be categorized into 2 clusters, where one cluster of apps (n=182, 41.7%) collected more data than apps in the other cluster. Conclusions Mental health apps are commonly targeted for everyone to use, but many apps are targeted toward teens or adults. Our study suggests that many publicly available mental health apps did not take the precautions (such as the involvement of appropriate health professionals, literature references, or conducting tests) to ensure that their content is valid and research based. Greater effort on behalf of mental health app developers is needed to ensure that the public is provided with high-quality apps. Moreover, our study indicates that the mental health apps that collect more data tend to score better on the ORCHA Baseline Review assessment.