JMIR Publications

ABSTRACT

Background:

Understanding patterns of real-world usage of mental health apps is key to maximizing apps’ potential to increase the public self-management of care. While developer-led studies have published results on the utilization of mental health apps deployed in real-world settings, to the best of our knowledge, no study has systematically examined usage patterns of a large sample of mental health apps relying on independently collected data.

Objective:

To present real-world objective data on user engagement with popular mental health apps.

Methods:

A systematic engine search was conducted using Google Play to identify Android apps with 10,000 installs or more, targeting anxiety, depression, or emotional well-being. Coding of apps included primary incorporated techniques and clinical focus. Behavioral data on real-world usage were obtained from a panel that provides aggregated non-personal information on user engagement with mobile apps.

Results:

Altogether 93 apps met the inclusion criteria (median number of installs = 100,000). The median percentage of daily active users (open rate) was 4.0% with a difference found between trackers (median = 6.3%) and peer-support apps (median=17.0%) in comparison to breathing exercise apps (median = 1.6%; Zs ≥ 3.42, Ps < .001). Among active users, daily minutes of use were significantly higher for mindfulness/meditation (median = 21:28) and peer support (median = 35:05) apps than for apps incorporating other techniques (tracker, breathing exercise, psychoeducation; medians range = 03:32-08:19; Zs ≥ 2.11, Ps < .05). The medians of app 15-day and 30-day retention rates were 3.9% and 3.3%, respectively. On day 30, peer support (median = 8.9%), mindfulness/meditation (median = 4.7%), and tracker apps (median = 6.1%) had significantly higher retention rates than breathing exercise apps (median = 0.0%; Zs ≥ 2.18, Ps ≤ .035). The pattern of daily use presented a descriptive peak toward the evening for apps incorporating most techniques (tracker, psychoeducation, and peer-support) with the exception of mindfulness/meditation, which exhibited two peaks (morning and night).

Conclusions:

While the number of app installs and daily active minutes of use may seem high, only a small portion of users actually utilize the apps for a long period of time. More studies leveraging different datasets are needed to understand this phenomenon and to better conceptualize our understanding of the ways in which users self-manage their condition in real-world settings.