In the last decade, the number of articles on HCI and health has increased dramatically. We extracted 139 papers on depression, anxiety and bipolar health issues from 10 years of SIGCHI conference proceedings. 72 of these were published in the last two years. A systematic analysis of this growing body of literature revealed that most innovation happens in automated diagnosis, and self-tracking, although there are innovative ideas in tangible interfaces. We noted an overemphasis on data production without consideration of how it leads to fruitful interventions. Moreover, we see a need to promote ethical practices for involvement of people living with affective disorders. Finally, although only 16 studies evaluate technologies in a clinical context, several forms of support and intervention illustrate how rich insights are gained from evaluations with real patients. Our findings highlight potential for growth in the design space of affective health technologies.

Background In the last decade, there has been a proliferation of mobile apps claiming to support the needs of people living with depression. However, it is unclear what functionality is actually provided by apps for depression, or for whom they are intended. Objective This paper aimed to explore the key features of top-rated apps for depression, including descriptive characteristics, functionality, and ethical concerns, to better inform the design of apps for depression. Methods We reviewed top-rated iPhone OS (iOS) and Android mobile apps for depression retrieved from app marketplaces in spring 2019. We applied a systematic analysis to review the selected apps, for which data were gathered from the 2 marketplaces and through direct use of the apps. We report an in-depth analysis of app functionality, namely, screening, tracking, and provision of interventions. Of the initially identified 482 apps, 29 apps met the criteria for inclusion in this review. Apps were included if they remained accessible at the moment of evaluation, were offered in mental health–relevant categories, received a review score greater than 4.0 out of 5.0 by more than 100 reviewers, and had depression as a primary target. Results The analysis revealed that a majority of apps specify the evidence base for their intervention (18/29, 62%), whereas a smaller proportion describes receiving clinical input into their design (12/29, 41%). All the selected apps are rated as suitable for children and adolescents on the marketplace, but 83% (24/29) do not provide a privacy policy consistent with their rating. The findings also show that most apps provide multiple functions. The most commonly implemented functions include provision of interventions (24/29, 83%) either as a digitalized therapeutic intervention or as support for mood expression; tracking (19/29, 66%) of moods, thoughts, or behaviors for supporting the intervention; and screening (9/29, 31%) to inform the decision to use the app and its intervention. Some apps include overtly negative content. Conclusions Currently available top-ranked apps for depression on the major marketplaces provide diverse functionality to benefit users across a range of age groups; however, guidelines and frameworks are still needed to ensure users’ privacy and safety while using them. Suggestions include clearly defining the age of the target population and explicit disclosure of the sharing of users’ sensitive data with third parties. In addition, we found an opportunity for apps to better leverage digital affordances for mitigating harm, for personalizing interventions, and for tracking multimodal content. The study further demonstrated the need to consider potential risks while using depression apps, including the use of nonvalidated screening tools, tracking negative moods or thinking patterns, and exposing users to negative emotional expression content.

Mindfulness meditation has significant benefits for health and well-being but requires training. A wealth of mindfulness meditation apps have been developed in the last years. However, there has been limited academic work evaluating these technologies. This paper reports an auto-ethnographic and expert evaluation study of 16 most popular iPhone mindfulness apps in the UK. Findings indicate that these apps focus mostly on guided meditation, with limited support for monitoring intrinsic meditation processes and measuring the effectiveness of the training. We propose a more nuanced discourse around such apps concluding with implications for design; including new tools for supporting intrinsic meditation processes and bodily kinetic aspects fostering mindfulness, together with the call for developing guidelines for evaluating the effectiveness of such applications.

Meditation is a mind-body practice with considerable wellbeing benefits which can take different forms. Novices usually start with focused attention meditation that supports regulation of attention towards an inward focus or internal bodily sensations and away from external stimuli or distractors. Most meditation technologies employ metaphorical mappings of meditative states to visual or soundscape representations to support awareness of mind wandering and attention regulation, although the rationale for such mappings is seldom articulated. Moreover, such external modalities also take the focus attention away from the body. We advance the concept of interoceptive interaction and employed the embodied metaphor theory to explore the design of mappings to the interoceptive sense of thermoception. We illustrate this concept with WarmMind, an on-body interface integrating heat actuators for mapping meditation states. We report on an exploratory study with 10 participants comparing our novel thermal metaphors for mapping meditation states with comparable ones, albeit in aural modality, as provided by Muse meditation app. Findings indicate a tension between the highly discoverable soundscape's metaphors which however hinder attention regulation, and the ambiguous thermal metaphors experienced as coming from the body, and supported attention regulation. We discuss the qualities of embodied metaphors underpinning this tension and propose an initial framework to inform the design of metaphorical mappings for meditation technologies. CCS CONCEPTS • Human-centered computing ~Interaction design ~Empirical studies in interaction design

Figure 1. Three objects created in workshops to materialize the lived experience of meditation using distinct embodied and material metaphors: (left) "The Healing Journey" by P5, (center) "Mandala" by P19, (right) "Meditation" by P12.