JMIR Publications

ABSTRACT

Background:

Mental health disorders are a growing public health concern among university students globally and in India, exacerbated by stigma and limited access to care. Mobile health (mHealth) apps offer a potential solution, but user engagement and cultural relevance remain challenges. This pilot study evaluates "Here for You," a mental health screening app co-developed with Indian university students to provide accessible, non-stigmatizing support.

Objective:

This study aimed to: (1) Describe the user-centered co-development and pilot testing process of the "Here for You" app; (2) Evaluate the app's feasibility, user acceptability, and engagement within the target population; and (3) Assess the concurrent validity of the app's screening tool (DASS-21) against established clinical measures (HAM-D, HAM-A, PSS).

Methods:

The study employed a four-phase, user-centred design involving students with lived mental health experience, clinicians, and developers. A purposive sample of 30 university students (mean age 21±1.8 years, 50% female) diagnosed with depression, anxiety, or stress participated. Participants completed the Depression, Anxiety, and Stress Scales-21 (DASS-21) via the app and underwent clinical assessments using HAM-D, HAM-A, and PSS scales. User experience was evaluated using the User Mobile App Rating Scale (UMARS) and qualitative feedback. Data analysis included Pearson correlations and thematic analysis.

Results:

App-based DASS-21 scores showed strong correlations with clinician-administered scales: HAM-D (r=0.819, p<0.001), HAM-A (r=0.887, p<0.001), and PSS (r=0.972, p<0.001), indicating high concurrent validity. The app received high usability ratings (mean UMARS score 4.4/5), particularly for functionality (4.7/5) and aesthetics (4.5/5). Qualitative feedback highlighted usability and enhanced privacy due to features like "Quick Exit," cultural resonance, and the desire for integrated support features. The co-design process directly addressed student concerns, implementing features like simplified language and crisis support links.

Conclusions:

This pilot study demonstrates the feasibility, validity, and user acceptability of the "Here for You" app, co-developed using a participatory approach with Indian university students. By integrating user experience, clinical rigor, and ethical safeguards like adherence to DPDP guidelines, the app offers a culturally resonant and scalable model for digital mental health screening in low-resource settings. This approach underscores the value of the "nothing about us without us" principle in developing effective mHealth interventions.