mHealth Solutions for Mental Health Screening and Diagnosis: A Review of App User Perspectives Using Sentiment and Thematic Analysis

Abstract

Mental health screening and diagnostic apps can provide an opportunity to reduce strain on mental health services, improve patient well-being, and increase access for underrepresented groups. Despite promise of their acceptability, many mental health apps on the market suffer from high dropout due to a multitude of issues. Understanding user opinions of currently available mental health apps beyond star ratings can provide knowledge which can inform the development of future mental health apps. This study aimed to conduct a review of current apps which offer screening and/or aid diagnosis of mental health conditions on the Apple app store (iOS), Google Play app store (Android), and using the m-health Index and Navigation Database (MIND). In addition, the study aimed to evaluate user experiences of the apps, identify common app features and determine which features are associated with app use discontinuation. The Apple app store, Google Play app store, and MIND were searched. User reviews and associated metadata were then extracted to perform a sentiment and thematic analysis. The final sample included 92 apps. 45.65% (n = 42) of these apps only screened for or diagnosed a single mental health condition and the most commonly assessed mental health condition was depression (38.04%, n = 35). 73.91% (n = 68) of the apps offered additional in-app features to the mental health assessment (e.g., mood tracking). The average user rating for the included apps was 3.70 (SD = 1.63) and just under two-thirds had a rating of four stars or above (65.09%, n = 442). Sentiment analysis revealed that 65.24%, n = 441 of the reviews had a positive sentiment. Ten themes were identified in the thematic analysis, with the most frequently occurring being performance (41.32%, n = 231) and functionality (39.18%, n = 219). In reviews which commented on app use discontinuation, functionality and accessibility in combination were the most frequent barriers to sustained app use (25.33%, n = 19). Despite the majority of user reviews demonstrating a positive sentiment, there are several areas of improvement to be addressed. User reviews can reveal ways to increase performance and functionality. App user reviews are a valuable resource for the development and future improvements of apps designed for mental health diagnosis and screening.

Asynchronous Technologies in Mental Health Care and Education

“…Most importantly, the design of digital health software tools must use patient and clinician input regarding the role of technology in the care continuum [ 37 •, 69 , 79 – 81 ]. Several articles [ 82 , 83 ] have discussed recent trends in changing attitudes of patients and clinicians in the use of technology for their health. As perspectives shift, we must find ways to provide useful technology-supported solutions for both digital natives and digital immigrants [ 19 ].…”

Implications of Online Self-Diagnosis in Psychiatry

“…The public may not realize that a screening tool identifies those at risk for a disorder, but does not provide a diagnosis. A study of 92 mental health screening apps found that less than half included a disclaimer in the app description, such as the result is not a diagnosis, or to consult a doctor [66]. Online counseling may increase feelings of self-stigma as compared to in-person counseling [67].…”