Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis
By Amit Baumel, Frederick J Muench, Stav Edan, J. Kane. Journal of Medical Internet Research, 2019
806 citations recorded by the source corpus.
Background Understanding patterns of real-world usage of mental health apps is key to maximizing their potential to increase public self-management of care. Although developer-led studies have published results on the use of mental health apps in real-world settings, no study yet has systematically examined usage patterns of a large sample of mental health apps relying on independently collected data. Objective Our aim is to present real-world objective data on user engagement with popular mental health apps. Methods A systematic engine search was conducted using Google Play to identify Android apps with 10,000 installs or more targeting anxiety, depression, or emotional well-being. Coding of apps included primary incorporated techniques and mental health focus. Behavioral data on real-world usage were obtained from a panel that provides aggregated nonpersonal information on user engagement with mobile apps. Results In total, 93 apps met the inclusion criteria (installs: median 100,000, IQR 90,000). The median percentage of daily active users (open rate) was 4.0% (IQR 4.7%) with a difference between trackers (median 6.3%, IQR 10.2%) and peer-support apps (median 17.0%) versus breathing exercise apps (median 1.6%, IQR 1.6%; all z≥3.42, all P<.001). Among active users, daily minutes of use were significantly higher for mindfulness/meditation (median 21.47, IQR 15.00) and peer support (median 35.08, n=2) apps than for apps incorporating other techniques (tracker, breathing exercise, psychoeducation: medians range 3.53-8.32; all z≥2.11, all P<.05). The medians of app 15-day and 30-day retention rates were 3.9% (IQR 10.3%) and 3.3% (IQR 6.2%), respectively. On day 30, peer support (median 8.9%, n=2), mindfulness/meditation (median 4.7%, IQR 6.2%), and tracker apps (median 6.1%, IQR 20.4%) had significantly higher retention rates than breathing exercise apps (median 0.0%, IQR 0.0%; all z≥2.18, all P≤.04). The pattern of daily use presented a descriptive peak toward the evening for apps incorporating most techniques (tracker, psychoeducation, and peer support) except mindfulness/meditation, which exhibited two peaks (morning and night). Conclusions Although the number of app installs and daily active minutes of use may seem high, only a small portion of users actually used the apps for a long period of time. More studies using different datasets are needed to understand this phenomenon and the ways in which users self-manage their condition in real-world settings.
Subfields: Applied Psychology, Experimental and Cognitive Psychology, General Health Professions
View Paper: https://www.semanticscholar.org/paper/c418736e20066949b3576cdc92bdb942a3ac4ec5
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Citations in the corpus
- Recommendations for policy and practice of telepsychotherapy and e-mental health in Europe and beyond. (2020, background): “Self-help applications, for example, show rapid declines in continued use, with only a small percentage of people relying on a smartphone application one month after installation (Baumel et al., 2019).”
- Large language models could change the future of behavioral healthcare: a proposal for responsible development and evaluation (2024, background): “However, these and other existing chatbots frequently struggle to understand and respond to unanticipated user responses 10,13 , which likely contributes to their low engagement and high dropout rates 14,15 .”
- Digital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrow (2020, background): “Picking from those different apps is challenging as many offer little protection of user data, make exaggerated claims, may be ineffective, and often are quickly abandoned because of usability issues [18,23,24].”