JMIR Publications

ABSTRACT

Background:

Accessible mental health care, delivered via mobile apps or online services, may be essential for military members (MM), public safety personnel (PSP), and veterans as they report numerous barriers to seeking in-person care and are at an increased risk for a number of psychological disorders.

Objective:

The aim of this environmental scan was to identify, describe and evaluate apps, web-based programs (WBP), and resource banks (RB), referred to as digital mental health (DMH) interventions, recommended for MM, PSP, and veterans. A multidimensional and multisystemic view of resilience and well-being were maintained throughout this environmental scan.

Methods:

Information was gathered from a comprehensive review of peer-reviewed literature, a google search, and a targeted search of websites relevant to the study populations. DMH interventions aimed at supporting resilience or well-being were included in the review, including those published in peer-reviewed articles, and those offered to these populations without research or literature backing their use.

Results:

In total, 69 programs were identified in this study, including 42 apps, eight WBPs and 19 online RBs, and were described based on three questions related to purpose, strategies and evidence, from the Adapted Mobile App Rating Scale (A-MARS) and the Mobile App Rating Scale (MARS). Each WBP and RB was then reviewed via the A-MARS and each app via the Alberta Rating Index for Apps (ARIA). Overall, 59% of DMH programs were recommended for veteran populations, 35% for MMs, and 29% for PSPs. The most common aim across WBPs, RBs, and apps was to increase happiness and/or well-being, and the most common strategies used were advice, tips, and/or skills training. Two apps recommended for MMs - PTSD Coach and Virtual Hope Box - received a high rating on the ARIA subscales and have also been trialed in non-randomized control trials (RCT; e.g., satisfaction, acceptability trials) with no contradictory evidence. Two apps recommended for PSP - PeerConnect and R2MR - have been trialed in non-RCT studies, with partially positive outcomes or little to no contradictory evidence and received a high rating on the ARIA. Finally, two apps recommended for veteran populations - PTSD Coach and VetChange - received high ratings on the ARIA and have been trialed via non-RCT studies, with positive outcomes and no contradictory evidence.

Conclusions:

In conclusion, there is a need for efficacy and effectiveness trials for DMH interventions for MM, PSP, and veterans to ensure they are effectively meeting the population's needs. While there appears to be many promising DMH interventions, further research is needed before these interventions continue to be promoted as effective and widely distributed.