Background Mental health digital apps hold promise for providing scalable solutions to individual self-care, education, and illness prevention. However, a problem with these apps is that they lack engaging user interfaces and experiences and thus potentially result in high attrition. Although guidelines for new digital interventions for adults have begun to examine engagement, there is a paucity of evidence on how to best address digital interventions for adolescents. As adolescence is a period of transition, during which the onset of many potentially lifelong mental health conditions frequently occurs, understanding how best to engage this population is crucial. Objective The study aims to detect potential barriers to engagement and to gather feedback on the current elements of app design regarding user experience, user interface, and content. Methods This study used a qualitative design. A sample of 14 adolescents was asked to use the app for 1 week and was interviewed using a semistructured interview schedule. The interviews were transcribed and analyzed using thematic analysis. Results Overall, 13 participants completed the interviews. The authors developed 6 main themes and 20 subthemes based on the data that influenced engagement with and the perceived usefulness of the app. Our main themes were timing, stigma, perception, congruity, usefulness, and user experience. Conclusions In line with previous research, we suggest how these aspects of app development should be considered for future apps that aim to prevent and manage mental health conditions.

The link between socioeconomic position and mental health is well established. On the macro level, one important determinant of this relationship is the welfare state. As such, welfare systems play an important role in mitigating the adverse effects of poor socioeconomic conditions and improving the mental health of the population. Despite their significance, welfare systems and their impact on mental health have rarely been examined. In this scoping review, we set out to synthesise the available evidence on this subject and offer preliminary evidence on how different welfare systems shape the mental health of societies. Eight databases were searched for articles published between January 2000 and March 2022 that focused on mental health and welfare regimes or welfare expenditure and compared OECD and EEA countries. The final review included 30 studies. Findings were summarised using narrative synthesis. Welfare systems were shown to have a significant relationship with the mental health of the population, with Social Democratic regimes and countries with more generous social expenditures demonstrating superior outcomes on most measures. It is suggested that a key factor behind these positive outcomes is the way in which these countries deal with social inequality. However, the overall composition of the included articles was highly heterogeneous and scattered across several domains. Moreover, important confounding factors such as differences in GPD across countries were often not taken into account. Therefore, the quality of the current evidence is considered weak. Further, questions are raised regarding the specific mental health benefits and drawbacks of welfare generosity for different populations and the specific pathways through which these systems may improve mental health in society. The review highlights the need for a more robust evidence base in this area and emphasises the importance of addressing the macro-level determinants of mental health.

BACKGROUND Mental health digital applications hold promise to provide scalable solutions to individual self-care, education, and illness prevention. However, a common problem with mental health apps is that they lack engaging user interfaces and experiences, often resulting in high attrition. While guidelines for new digital interventions in adults have begun to examine engagement, there is a paucity of evidence in how to best address digital interventions in adolescents. As adolescence is a period of great transition and can lead to a vulnerability to mental illness in later life, understanding how best to engage this population is crucial. OBJECTIVE In this study we sought to gather qualitative evidence in a sample of adolescents in the UK about their experience of a mental health app. METHODS We used the COREQ guidelines for reporting qualitative data. Adolescents were asked to use the app for a week and were then interviewed using a semi-structured questionnaire. RESULTS Authors developed five themes from the data that were important in whether the app was perceived to be useful and effective: User Experience/User Interface such as loading screens and portrait mode, specific Location and Frequency of app access, Effectiveness of the app for mental health goals, Content, e.g. games and meditation, and the Reasons for Use , i.e. what participants’ goals were before using the app. CONCLUSIONS In convergence with previous research, we suggest these aspects of app development should be considered crucial in future apps aimed at preventing and supporting mental illness. CLINICALTRIAL TCYP171110