Aspects to consider when developing a mental health app

Anyone who decides to build a mental health app faces challenges with understanding the functionality and design components necessary to provide the most benefit to users. Even doctors who have been practicing for years find it hard to apply their knowledge and experience to the development of mental health apps. 

An app’s design may alienate users, or in-app mechanisms may not sufficiently motivate them to take steps to overcome a mental health illness. Users might also abandon an app if they aren’t receiving the support they expect. The list of possible issues goes on and on.

In order to develop digital medicine solutions that meet many people’s needs, it’s important to follow an all-around UX approach. The purpose of this article is to acquaint you with this approach. But first, let’s look through the main arguments for creating a mental health app.

People all around the world suffer from depression, behavioral disorders, and mental illnesses. Many can’t afford traditional therapy, worry about the stigma of in-office treatment, or don’t have access to treatment for various reasons. 

Statistics by the Anxiety and Depression Association of America show that 40 million adults in the US suffer from anxiety disorders. Global statistics from the same source show that nearly 75 percent of people with mental disorders go untreated in developing countries. This proves the need for accessible and effective treatment. 

On the other hand, many mentally healthy people want to find an internal balance and live more fulfilling lives but aren’t interested in traditional therapy. 

Huge demand for mental healthcare

The coronavirus pandemic has revealed deep cracks in the US behavioral healthcare system. People across all demographics in the US are feeling isolated, lonely, and anxious. 

Take people who are employed, for example. According to a report by The Standard, nearly 46 percent of over 1,400 workers interviewed at the end of 2020 stated they were suffering from a mental health issue, compared to 39 percent a year before. Fifty-five percent of those surveyed stated that a mental health issue had worsened since the pandemic began.

Now that it’s been almost two years since we entered the era of Covid, it may seem that we’ve gotten used to social distancing and found ways to overcome the virus-related panic. But the US Centers for Disease Control and Prevention (CDC) reports that the number of adults with symptoms of anxiety or depressive disorders keeps growing, and as of February 2021, 41.5 percent of all people in the US were experiencing mental health issues.

Harvard Business Review reports that organizations of different sizes increased investments in treating employees’ mental health disorders in 2021, from increasing paid time off and adding company-wide mental health days to providing mental health training. In this situation, mental health apps can complement medication and contribute to employees’ well-being. 

A spike in downloads of apps like Talkspace and BetterHelp since the beginning of the coronavirus pandemic demonstrates people’s need for mental mHealth solutions. They can be an alternative to traditional therapy as they’re lighter on the wallet, available to all smartphone users, and ensure privacy. But does the availability of popular mental health apps mean there’s no room for new solutions?

Room for improvement in digital mental health 

Even such giants as Talkspace that have been on the market for a decade have their drawbacks. For example, Talkspace isn’t suited for children under the age of 13. Similarly, other popular platforms don’t meet all users’ expectations.    

According to the Digital Mental Health Revolution report, nearly 100 mental health startups appear every year. However, lots of these apps and startups underperform.

Let’s consider apps for treating anxiety, one of the most common mental health issues. A study published by the Journal of Consulting and Clinical Psychology found that just two apps, Headspace and Calm, account for 90% of active users, as of 2020. 

Developing an effective mobile mental health solution that benefits users requires the cooperation of mental health professionals and software solution providers. You should take a careful approach to identifying your app’s specialization and providing a service that will directly address your target audience’s needs. 

The first thing for a medical practice to decide when building a mental health app is what the app should focus on. This decision will affect all of the app’s logic and will be critical for mental solutions development and their subsequent success.

Mental health apps can be designed for different age groups, genders, and demographics. For instance, the BlueIce app is tailored to young people, taking into account the psychological characteristics of this age group. However, some mental health apps target all age groups, genders, and segments of the population. These apps are more challenging to create, as they require you to consider many more factors.

Mental health functionality might also become part of an app tailored to dealing with other health issues, as there’s a connection between behavioral and physical health. For instance, Welldoc, a platform for managing chronic conditions like diabetes and hypertension, has recently added mental health tools. 

Roughly speaking, we can divide mental health apps into three categories. Mental disorder apps are tailored to the treatment of certain mental illnesses. Mental self-improvement apps are designed to improve the psychological state of mentally healthy people. Mental health apps can also be generalists dedicated to anyone with mental health needs. Let’s look at the peculiarities of apps in these three categories. 

Mental disorder apps

There are literally thousands of apps on the market for people living with depression. Some are built on the principle of exchanging messages or having calls with doctors, while others offer tips, self-guided mood training programs, and elements of gamification. The anti-depression app MoodTools takes depression seriously, ensuring a suicide safety plan is in place in case of a crisis.

Besides apps for depression, there are also apps tailored to treating conditions such as schizophrenia and psychoses. 

However, doctors claim that apps designed for people with psychological disorders are ideally a supplement to traditional therapy; unlike apps for mentally healthy people, apps for people with psychological disorders must have doctors on board. These in-app professionals should be responsible for providing specialized support 24/7, thereby bringing maximum benefit to users.

In addition, apps for people with mental disorders often connect people sharing the same diagnosis, building communities. This helps users share feelings with those who will understand and support them. Yalantis has experience building an enterprise healthcare system with communities. This system brings together a patient’s relatives, caregivers, and doctors and ensures a secure connection between them. 

Mental self-improvement apps

Mental health apps can be created for mentally healthy people wanting to monitor their mood swings, cultivate positive thinking, and break bad habits. 

Meditation is often at the heart of these apps. For example, Calm uses meditation techniques as its core feature, since many people find them effective for handling stress and relaxing. 

Apps like Self-help for Anxiety Management provide other self-monitoring and self-help techniques, such as physical and mental relaxation for those who don’t find meditation effective.

Some existing solutions for mentally healthy people also offer in-app psychologists for those who want to enlist the support of professionals to overcome mental illnesses.

In general, apps for mentally healthy individuals can be divided into general mental health apps, apps for addiction recovery, and stress-management apps.

General mental health apps. These apps enable users to enhance their self-awareness by controlling their mood, maintaining good habits and breaking bad ones, and cultivating positive thinking. For example, What’s Up? provides more than 100 questions to recognize your feelings and a Thinking Patterns page that helps you overcome negative thought patterns. The 7 Cups app has free trained “active listeners” available, who volunteer to care for people needing psychological help.

Apps for addiction recovery. The main purpose of these apps is to help people beat bad habits such as drinking, smoking, and taking drugs. Additionally, these apps allow people to track how much time has passed since they started fighting a bad habit. Twenty-Four Hours a Day, based on the bestselling book with that title, offers twelve steps to finally get rid of a bad habit.

Stress and anxiety apps specialize in helping people struggling with stress and anxiety. By providing 24-hour anxiety toolkits and diaries, they enable users to track and document thoughts that provoke restlessness. For instance, CBT Thought Record Diary, a mental health tracker app claims to help users make long-lasting changes to their thinking patterns and behavior.

Mental health apps for all

One app can be tailored to both mentally healthy individuals and those who suffer from serious mental disorders. Some mental health apps offer a range of services from doctors who provide scheduled care. For instance, Talkspace has thousands of licensed therapists available via text, video, and voice call. 

Using communication technologies to access healthcare services has become a trend during the pandemic. In April 2020, there was an incredible spike in the use of telehealth services for office visits and outpatient care — according to McKinsey, there were 78 times more telehealth visits in April than in February 2020. This prompted the accelerated development of telehealth software solutions. At Yalantis, we have extensive experience creating telehealth solutions including Medical PACS as well as developing healthcare platforms for enterprise needs.

Once you’ve decided on your app’s specialization, the next step is to define the app’s functionality built around the core value it will deliver: provision of mental health services.

Read also: Getting Started in Telehealth: How to Implement Virtual Visits in Your Practice

There are a variety of tools and techniques that can be implemented in modern mental health apps, including cognitive behavioral and acceptance and commitment therapies, mood training programs, gamification, customized settings, and forums. 

So as not to get confused by this great variety and not to offer redundant functionality, it’s best to draw a plan explaining how your app will handle a user’s mental illness. Each step of the plan should be matched to relevant features.

We’ve identified four essential features of a number of top-notch, feature-rich mental health solutions that have onboard therapists and are tailored to self-care. Some or all of these features may be implemented in a mental health app for healthy people and for those with mental disorders.

Self-monitoring. Mentally healthy people mainly use stress-management apps to explore their mood patterns and handle stress, while people with mental disorders use these apps to track their symptoms and progress. RR: Eating Disorder Management is much appreciated by users, as it helps them conduct self-monitoring and record meals, thoughts, and feelings.

Notifications and reminders. Notifications offer tailored suggestions, encouraging self-monitoring. Reminders suggest that users practice relaxation, go for a walk, and do other things that are good for their psychological state. Busy users find it helpful to get notifications reminding them to perform mental health exercises. However, too many notifications are likely to annoy users, as psychologists warn that constant notifications are a toxic source of stress. 

Sharing. This feature enables users to share on social networking sites to get support from friends or share directly with third-party healthcare providers, family members, and caregivers. iMoodJournal is highly rated by users for its Sharing Moods feature, which allows people to share their moods on social media, export their data in different formats, and send it via email.

Support groups. Lots of people find support groups helpful for overcoming their mental health illnesses. By sharing your experience in a safe and confidential setting, you can gain hope and develop supportive relationships. Users can take part in discussions with people sharing their mental health disorders. These groups are usually monitored by a mental health professional. For instance, What’s Up? provides open forums for discussions among users. 

Though there are mobile apps with in-app doctors, a web-based mental health service that provides all the information needed by patients and therapists is preferable. The following list of features applies to apps that have onboard therapists:

Matching clients with therapists. Based on information provided by a person seeking a consultation, a matching algorithm can recommend suitable doctors to choose from. Talkspace provides a welcoming therapist who, during a conversation with a new user, matches them with the most relevant doctor by asking a set of questions.

Dashboard for therapists. These dashboards are usually available on a provider’s website. They’re tailored to therapists and allow them to manage cases and record patient progress to keep all information in one place. This information is received from customers through their smartphones by means of customizable surveys and journals tailored to a disorder or illness. This data is securely forwarded to the therapist’s web-based dashboard and shown in the form of understandable reports. A therapist can look through these reports before a session or together with the patient.

Text/audio/video messaging and chats. Communication within an app is usually performed via text messages. This feature is appreciated by users who don’t have the privacy to talk with a therapist out loud. A mental health app can also provide communication with therapists by means of audio and video messages as well as live video and audio sessions, allowing the patient to choose the most comfortable communication channel. 

Read also: An Extensive Guide to Messaging App Development

The tech stack you choose for your mental health app should correspond to your aims and the features you implement to achieve them. Key factors to take into account are project complexity, project scope, and the resources available within your team or in the market. 

As a rule, the basic tech stack for a mental health app includes Python, PHP, and Node.js on the back end. The front end is developed using JavaScript in combination with React.js or Angular. React Native is often chosen for mobile development. PostgreSQL and MongoDB are popular database choices, while AWS is known to provide powerful and scalable cloud computing capabilities. Additionally, you may consider using Amazon S3 Bucket for developing a messaging feature from scratch. 

Integrations with third-party services are vital to make your app fully functional. We suggest implementing Firebase Cloud Messaging to send push notifications. Twilio can be a good choice for in-app calling and messaging. You should also integrate a payment gateway like Braintree, PayPal, or Stripe, all of which are known to offer a smooth user experience. Finally, set up map integration and enable user location tracking with Google Maps API, MapKit, or CoreLocation.

Cybersecurity in general and data privacy in particular are critical when it comes to creating a successful and reliable mental health app. One reason why people prefer medical mobile applications for mental health to traditional therapy is that they consider them safe. The privacy of an app helps individuals minimize the number of people who know sensitive medical information.
There are various regulations, laws, and standards for mobile mental health providers to take into account. 
HIPAA compliance. When it comes to health apps, it’s often tricky to determine if HIPAA Privacy and Security Rules apply. To figure that out, answer three questions: 

• Who will use the app? 
• What information will the app process? 
• Will the app be used by a covered entity (doctor, hospital, or health plan)?  

Making your mobile software HIPAA compliant presupposes implementing HIPAA security standards that include:

1. Technical safeguards that deal with cybersecurity and network infrastructure, such as firewalls, encryption, and malware protection
2. Physical safeguards such as locks and alarm systems that are meant to limit and control access to websites where ePHI is housed or maintained
3. Administrative safeguards that represent a set of policies, procedures, documentation, and staff training to ensure that organizations implement and follow security standards.

Most mental health apps on the Google Play Store and the App Store don’t fall under HIPAA. This is because these apps are designed for a patient’s personal use. They don’t share private information with covered entities and don’t contain protected health information (PHI).

A healthcare app becomes subject to HIPAA if it includes protected health information, such as information about a user’s physical and mental conditions, digital healthcare services, payment details, and other information that can be traced back to a specific patient. If a covered entity uses an app, that app will also most likely have to comply with HIPAA regulations. 

Read also: HIPAA Requirements and Other Regulations Imposed on Medical Software

GDPR privacy standards. Client data must be stored in an anonymized form according to GDPR requirements, a set of European Union regulations on how businesses must manage personal data. A company that’s based in the US and has clients in The EU needs to comply with GDPR regulations to avoid penalties.

Regulatory guidelines. Mental health services must be provided only by licensed therapists in order to avoid criminal and civil penalties. In-app therapists also have to be acquainted with federal and state laws (in the US), as mental health practices are regulated at the federal and state levels. If you’re not sure about what regulations your app should meet, use this interactive mobile health apps tool designed by the Federal Trade Commission.

Encrypting app data. Stored or shared data has to be encrypted at all stages. Encryption implies translating data into an unreadable form or using a secret code to provide access to this data only to people who have the code.

Passcodes, usernames, and biometrics. A username and password allowing a client to log in to their account adds security to an app. Biometric authentication techniques such as fingerprint and iris scans, facial recognition, and voice scanning are a step toward sophisticated security for mental health apps.   

Read also:  Secure Application Development: from Planning to Production

Before getting down to creating your app, we recommend you research similar solutions available on the market. There are two well-established frameworks for assessing mental health apps. 

The first is the American Psychiatric Association App Evaluation Model. Following this model, you can filter thousands of behavioral health apps and assess selected apps based on several key criteria.

The second is reading app reviews on PsyberGuide, a non-profit website that rates mental health apps based on credibility, transparency, and user experience. This website is credible, as the information it provides is the result of the contribution of an academic management team and a scientific board of directors.

Make sure you also take into account the following aspects:     

In-app human support. If an app offers psychiatric assistance, it’s important that it provides an opportunity to receive support from doctors. This might mean the ability to get in touch with specialists or with a support system in case of an attack of suicidal thoughts or any other emergency situation. 

Clinical basis. There are tried and tested therapeutic approaches that clinicians use to treat mental disorders. Effective online mental health tools must follow well-researched approaches. We strongly recommend you consult with medical practitioners right from the offset through the end of the development process. In consultation with mental health specialists, you can create questionnaires that allow users to provide feedback about the severity of symptoms and offer evidence-based exercises. 

Comprehensive testing. Usability testing is even more important for health mental apps than for other apps. Some mental disorders interfere with people’s ability to concentrate. Make sure to evaluate your app’s user acceptance through formal beta testing and subsequent studies.

Read also:  Best Practices to Performing Testing and Quality Assurance

Understanding the target audience. A mental health app should be designed to engage users and meet their needs. To make sure your app does this, answer the following questions:

• What will motivate the target audience to become regular users? 
• How and how often will the app send notifications to users? 
• How will the app be interwoven into a user’s daily routine?
• What might annoy users (frequent surveys and controversial questions, for instance)? How can we avoid these things?
• What other factors related to the target audience — culture, financial position, background, age — must be taken into account?

Visual design and audio. UI and UX design, as well as in-app audio are of the utmost importance for a mental health app. When designing a mental health app, pay special attention to the following components:

• Onboarding
• Overall simplicity of use
• Smoothness of user interactions

Your app should calm users, and should therefore be aesthetically pleasing and easy to use. For example, #SelfCare, with its self-care game in which a user virtually chills in bed, has worked with guest artists on the app’s design and provides constant updates.

Motivational triggers. People often download mental health apps to achieve goals they can’t achieve on their own. This means a mental health app should offer achievement awards such as digital coins and badges as components of gamification, giving users a sense of accomplishment. Smiling Mind awards badges for some meditation-related achievements. However, motivational triggers don’t necessarily apply to a mental health app, as their effectiveness will depend on the disorders the app is designed to address. Some apps such as #SelfCare calm users by assuring them there’s no purpose and no obligations — only enjoyment.

Positive communication. People seeking psychological help need support and acceptance, and they may count as an insult any ambiguities. Thus, if an app is intended to have a social community, it has to be monitored by moderators to make sure all interactions are delicate and positive. 

Value-added services. Think about what supplementary services might help your app stand out and benefit users. For example, Ginger, a mental health platform, will shortly offer its users same-day medication delivery. After consulting with the platform’s psychiatrists, users will be able to fill their prescriptions through the digital Capsule pharmacy and order free delivery in select locations.

If you consider all of these nuances, your app is likely to be an effective mental health tool and be in demand among people seeking mental healthcare services. If you’ve come up with an idea for an app for addressing mental health illnesses, our software development company will gladly contribute to the realization of your custom mobile application.