Currently submitted to: JMIR Formative Research
Date Submitted: Apr 7, 2026
Open Peer Review Period: Apr 8, 2026 - Jun 3, 2026
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Do Star Ratings Reflect User Needs? Analyzing User Experiences and Perceptions with Mental Health Mobile Applications
ABSTRACT
Background:
With the rise of digital health, mental health applications (MHapps) have become increasingly popular to support self-management of depression, anxiety, and stress. Star-ratings are often used as indicators of app quality. However, they do not fully capture if the MHapp reflects real-life user experiences. Instead, examining the patterns of engagement and app usage can highlight whether high ratings align with diverse user needs.
Objective:
This study analyzes the user experience of top-rated depression and anxiety apps and assesses user perceptions with apps that have higher star ratings based on user reviews.
Methods:
To identify relevant mobile applications, we used a systematic search strategy that mimicked a user’s journey and identified the five most highly rated MHapps with approximately 750 user reviews. Using a hybrid coding technique informed by prior literature, we analyzed reviews to identify emerging themes that explained user experiences.
Results:
User experiences reflected a complex interplay between perceived benefits and frustration. While users valued conveniences and accessibility to mental health resources, they raised significant concerns and criticism focused on interface design, limited features, functionality, and technical support. Additionally, pricing structure, subscription gatekeeping and privacy concerns followed initial use satisfaction among users.
Conclusions:
App usability elicited paradoxical responses and showed multiple overlapping themes showcasing features that may support some users, can hinder others. This study highlights the complexity of user perceptions influencing experience with self-management MHapps. It emphasizes that star ratings are not sufficient to reflect if a MHapp meets user needs, and continued improvement in app design is needed to meet the diverse needs of users for better engagement and satisfaction. Clinical Trial: NA
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