JMIR Publications

ABSTRACT

Background:

The mental health app sector in India is growing rapidly. This is driven by increasing smartphone usage, internet penetration, popularity of digital initiatives, and growing recognition of mental health challenges in public discourse, along with supply and demand-side barriers to seeking professional help and the rise of mental health tech startups. While digital mental health solutions offer scalable ways to address unmet needs, concerns arise regarding app quality, privacy, and safety due to rapid market expansion, regulatory challenges, and limited empirical research. We conducted a comprehensive and systematic review of smartphone-based mental health apps accessible to Indian users on app stores.

Objective:

The study aimed to describe apps in terms of characteristics such as nature of the functions, involvement of mental health professionals in development, mention of empirical basis, nudges to seek professional help as well as evaluate app-quality.

Methods:

This systematic review of mental health apps was performed utilizing the Target user, Evaluation focus, Connectedness and Health domain approach and the PASSR (Protocol for App Store Systematic Reviews) checklist. Fifteen search terms covering mental health conditions and therapies were used on Android and iOS stores. Identified apps were screened based on inclusion and exclusion criteria, then downloaded for detailed review. Data were extracted based on pre- decided parameters. Additionally, the apps were rated for quality using the Mobile Application Rating Scale (MARS).

Results:

The initial search yielded 5,827 apps and 350 were reviewed in detail after removing duplicates and applying eligibility criteria. Common search terms such as “depression” and “anxiety” yielded 27% to 25% of relevant apps. Seventeen percent of reviewed apps originated from Asia, and 37% focused on a single mental health condition. Multifunction apps (e.g., assessment and intervention) formed the largest category (65%). Privacy concerns were notable, e.g. 15% lacking a mention of data-sharing policy. Most apps were developed by commercial organizations, and 65% did not mention mental health professional involvement, while 13% cursorily mentioned it. 11% of the apps mentioned empirical research on the app. Empirical-basis for the app- content was not mentioned in more than half of the apps. Pointers to seek professional help were evident in 40% of the apps, mostly in terms of disclaimers, but nudges or motivational prompts to seek professional help were evident in slightly less than a quarter of the apps. Only 30% attempted to dispel mental health myths. Functionality and aesthetics ratings on MARS were relatively high, but 14% of apps scored 3 or lower on the information subscale.

Conclusions:

This is among the first systematic reviews of mental health apps accessible to Indian users on Play Store and Apple App Store. The findings offer insights for further research, development, and policy-making in the digital mental health space. Clinical Trial: International Platform of Registered Systematic Review and Meta-analysis Protocols, INPLASY2024100035; https://inplasy.com/inplasy-2024-10-0035/