1. In this systematic review, less than half of newly developed mental health apps had been successfully implemented.

2. Furthermore, barriers such as high cost, funding restrictions, and length of research time impeded successful implementation of mental health apps.

Evidence Rating Level: 1 (Excellent)

Smartphone apps are thought to be an innovative way to address issues of accessibility and scalability in mental health interventions. However, there has not been any systematic assessment of the implementation of all evidence-based mental health apps for young people. As a result, the objective of the present systematic review was to determine the proportion of successfully implemented mental health apps, as well as the factors affecting the real-world implementation of these applications.

Of 26,311 identified records, 34 (n=29 unique apps) studies from January 2011-February 2021 were included in the final review. Studies were included if they reviewed the efficacy of native mobile apps designed to prevent or treat mental health problems or promote wellbeing in young people (age 15-25 years) and if the primary outcome was a measure of mental health. Studies were excluded if the intervention was a non-mobile app intervention, if the app was not efficacious in improving mental health, or if appropriate outcomes were not reported. Study quality was performed using the mixed methods appraisal tool. The review was conducted in accordance with the PRISMA guidelines. The primary outcome was the proportion of evidence-based mental health apps successfully implemented after development.

Results demonstrated that of 21 newly developed mental health and wellbeing apps, 9 were still available, while the remaining 12 were not, indicating a 43% implementation success rate of new apps. With respect to barriers to implementation, factors such as high cost, time, funding restraints, and long research processes were identified. Further challenges included the rapid development of technology, commercial competition, and user acquisition. However, the study was limited by the fact that the majority of participants in the included studies were older than age 20, which may limit the generalizability to adolescents. Nonetheless, these results demonstrate real-world issues that impede the successful implementation of mental health apps for youth.

Click to read the study in Journal of Medical Internet Research

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