JMIR Publications

ABSTRACT

Background:

Rising global demand for mental health services strains traditional care models, a trend mirrored in New Zealand where the Integrated Primary Mental Health and Addictions (IPMHA) model was introduced to improve access to care. While the IPMHA model shows promise, significant service-delivery challenges undermine its scalability. Digital mental health tools (DMHTs) present an opportunity for digital optimization, yet their effectiveness is often limited by low practitioner adoption, a persistent implementation barrier. To ensure these tools are impactful, a user-centered DMHT design approach may help to mitigate practitioner adoption barriers and create solutions that can be seamlessly integrated into clinical workflows.

Objective:

Reporting on the Test stage of the five-stage Design Thinking framework, this study aimed to evaluate the usability and acceptability of a DMHT software prototype intended to support Health Improvement Practitioners (HIPs) working within New Zealand’s IPMHA model.

Methods:

Five HIPs from a single Primary Health Organization (PHO) participated in semi-structured usability interviews. Data were collected using a think-aloud protocol during mock clinical sessions and analyzed using affinity diagramming to identify key software feature requirements necessary to promote usability, adoption, and workflow integration.

Results:

Feedback was obtained for all software MVP features. While practitioners found the clinical support features valuable, two system-level requirements were identified as prerequisites for adoption. The first was administrative optimization: the DMHT must reduce workload by automating tasks like clinical note entry, data reporting, and psychometric scoring. The second was seamless integration with existing clinic patient management software to eliminate double-handling of data and solve IT-related workflow frustrations.

Conclusions:

For a DMHT to be successfully adopted by IPMHA practitioners, it must primarily function to solve existing administrative and workflow inefficiencies. Clinical support features such as the provision of therapeutic tools and exercises, though helpful, are secondary to the tool's ability to be a practical, efficient, and fully integrated component of daily practice. These findings underscore the value of user-centered design in uncovering the pragmatic, systems-level needs of end-users in a complex primary care service-delivery context.