Exploring user experiences in a digital mental health app through qualitative thematic analysis

Abstract

Background

In the recent times, the field of mental health is witnessing rolling out of digital mental health applications (apps) as a newer medium of mental health support, particularly for young adults navigating academic and life transitions. There are number of mental health apps being launched but survival and effectiveness of apps depend on various factors. As per few research studies on mental health applications, apps such as Wysa, Woebot, Talkspace, Headspace, etc. are performing well in this field. Whereas, some apps are unable to suffice the set purpose to the benefit of the users. Moreover, these apps are reaching to the people who are well versed with digital technology but leaving behind the ones unfamiliar or less familiar with the digital ecosystem. In some cases, these apps are also the first point of contact further powered by Artificial Intelligence integration. It would be of interest to understand that how these apps are being viewed by the users. As users provide important insight into the app features and effectivity to relieve their distress. Users’ experiences are key to transform the mental health apps which is a viable option to narrow down the service demand and supply gap. Quality, effectivity with ethical standards are important area of current study as these apps are seen as feasible medium to combat diverse and growing mental health needs.

Objective

This study aims to explore user experiences, perceptions, and reported benefits and challenges associated with a digital mental health application by conducting a qualitative thematic analysis of publicly available user reviews.

Methods

This study used a user-led approach to analyze reviews (n = 3249) of the mental health app Amaha posted on the Google Play Store over a 3 years period to discover determinants for engagement and helpfulness in digital mental health. Amaha, was created in 2016 by an Indian team operating as a private entity, and offers to provide free with in app purchases mental health support to 18 and above individuals in India and with free primary information and education on mental health but advanced support comes with in-app purchase features and plans. The reported user experience was categorized and assessed into the fundamental domains of acceptability, usability, utility, and integration through the analysis of keywords in the user feedback. Along with identifying the app’s main merits and shortcomings, the study also looked at the prominent features of the user types giving important information on characteristics of people accessing digital mental health care.

Results

The analysis consisted of 3249 reviews from the year 2022 to 2025, out of which 2764 were positively rated reviews and 363 were negatively rated. The app’s acceptability was demonstrated by its interactive design, entertaining exercises, and Chatbot conversational skills; its usability was emphasized by its non-judgmental nature and ease of talking. Themes including cognitive restructuring activities, easy access, and mental health enhancement demonstrated the app’s value. Users’ desire for the app’s integrated features was highlighted by themes of privacy and confidentiality. However, affordability of the app and technical glitches were discouraging factors to using the application. Subsequent investigation identified typically four main emerging patterns in users including people communicating symptoms of depression, anxiety, stress or loneliness.

Conclusion

As digital platforms are transforming mental health care, it is imperative to ensure that these tools foster genuine care and support in addition to providing scientifically sound psychological interventions, especially in low-resource settings. Knowing how users interact with Digital mental health apps is essential to understand people’s expectations and nature of app usage. By offering insights that may benefit users, mental health professionals, and app developers this research advances the field of digital therapeutic solutions and brings out the trust factors and challenges in affordability of the private run mental health apps. The findings may hold important implications for universities and educational institutions exploring scalable and accessible mental health support systems for students in hybrid and post-pandemic learning environments.

Introduction

Background

Digital Mental health Applications has revolutionized the way people obtain mental health resources and assistance in recent years [1, 2]. At the forefront of this change are AI-powered mental health applications, which offer users personalized and convenient ways to deal with their mental health issues. These programs use powerful algorithms and data analytics to give personalized interventions, mood tracking, and therapeutic exercises, making mental health care more accessible than ever before [1]. These apps can accommodate each user’s unique needs by analysing their behavior and preferences, which makes therapy more successful and engaging. Digital mental health apps are becoming a practical tool for increasing mental health awareness, lowering stigma, and quickly treating individuals in need as society adopts technology.

A comparative analysis of mental health landscapes: india and the global context

By the age of 75, one in two adults will have suffered from at least one mental health disease. Mental health treatment receives about 2% of global health budgets, and even in the wealthiest nations, less than half of the requirement is met. The standard of mental health treatment is far lower than that of physical health care. Individuals with various mental disorders pass away 15–20 years before the average person [2, 3]. One in three women and one in five men from all walks of life suffer from depression, which is a major cause of disability globally [4]. Over 700,000 people die by suicide each year because of depression, which can worsen if left untreated [5]. Access to high-quality mental health care is a major issue worldwide [6], anxiety and sadness were the most prevalent mental illnesses in 2019, affecting 970 million individuals worldwide. One out of every 6 years of disability worldwide is caused by mental illnesses [2].

According to the National Institute of Mental Health and Neurosciences’ National Mental Health Survey, the overall weighted prevalence of any mental health illness was 13.7%. For a variety of mental diseases, the average treatment gap varied from 70% to 92% [7].According to developed-nation standards, there should be 1/10,000 psychiatrists, psychologists, mental health nurses and psychiatric social workers. But according to current statistics, there are 0.2 psychiatrists for every 100,000 people in India, 0.03/100,000 psychologists, 0.03/100,000 psychiatric social workers, and 0.05/100,000 mental health nurses [8] Given the scarcity of mental health specialists, bridging this enormous gap will need a variety of creative strategies [9].

Addressing the mental health crisis: the potential of digital mental health apps

Digital interfaces are becoming a good substitute in this situation for closing this gap, lowering the cost, and increasing the accessibility of psychiatric diagnosis and treatment [10]. Additionally, the stigma attached to mental illnesses makes it difficult to get good care. Many times, young adults and college students are reluctant or lack the time to consult a therapist for their mental health issues. A few years ago, Digital health interventions made its debut in the field of medicine. Since then, it has also had an impact on mental health. In psychiatry, Digital mental health apps has shown helpful in predicting and preventing suicide, identifying predictors for treatment response, and determining which specific medication is appropriate for a certain patient [9]. Along with Digital mental health apps, AI is capable of processing large datasets with ease and enabling the analysis of intricate patterns and relationships, among other amazing things [11].

By offering solutions and insights that were previously unattainable through traditional approaches, Digital mental health apps (DMHA) holds the potential to completely transform mental healthcare, a field where comprehending complicated human emotions and behaviours is crucial [12, 13]. Personalized treatments, virtual therapeutic platforms, and sophisticated detecting methods are all provided by this game-changing instrument. It is a game-changing tool that provides virtual therapeutic platforms, customized therapies, and sophisticated detecting techniques. It might increase access to healthcare, lessen stigma, and enhance the effectiveness of treatment [14, 15]. The field of mental healthcare is changing because of the integration of technology; it is a revolution in mental health and wellness [16].

Digital mental health and post-pandemic student wellbeing

University students and young adults have emerged as one of the populations most vulnerable to psychological distress in post-pandemic contexts. Studies show that there was a significant increase in usage of mental health apps during and after the pandemic [17, 18]. Academic pressure, uncertainty regarding careers, social isolation, financial stress, and the transition toward hybrid and digitally mediated educational environments have contributed to increasing levels of anxiety, stress, burnout, and emotional exhaustion among students. Despite growing mental health needs, many students continue to face barriers in accessing traditional psychological services due to stigma, affordability concerns, limited institutional resources, and time constraints [19]. Consequently, digital mental health applications are increasingly being explored as scalable, accessible, and flexible tools that may supplement conventional counselling and wellbeing support systems within educational settings.

Potential risks and ethical dilemmas of digital mental health apps (DMHA)

With the introduction of technology, the mental health environment in India and around the world offers a complex interplay of benefits and difficulties. Nonetheless, it is important to thoroughly examine ethical implications of offering mental health treatment digitally. Digital mental health apps should not take the place of skilled professionals’ nuanced care, even though they can improve accessibility and offer additional support [20, 21]. Particularly in low-resource countries where mental health services are already scarce, an excessive dependence on AI solutions associated with digital mental health apps runs the danger of lowering the quality of care [20, 22]. Furthermore, a careful assessment of these technologies is required due to worries about data privacy, algorithm openness, and the possibility of bias in Digital mental health apps [22–25]. As these applications become more widespread, it is crucial to make sure that they are created with moral principles in mind, encouraging openness and responsibility [26, 27].

Targeted mental health conditions: scope and application of digital mental health apps

“We found that there is an uneven use of Digital applications in mental health research, with a primary focus on psychotic disorders such as schizophrenia and depression. This implies that we are still unsure of how they can be used to study other mental health concerns, according to WHO/Europe’s Regional Advisor for Mental Health, Dr. Ledia Lazeri [28] Among the most common conditions that mental health applications treat is anxiety. Numerous apps provide self-management features for mindfulness, relaxation, and cognitive behavioral tactics to assist users deal with the symptoms of anxiety [29, 30]. Several apps focus exclusively on anxiety treatment, employing strategies that encourage self-control and emotional intelligence [31].

A lot of well-known mental health applications offer evidence-based information and therapeutic exercises to help people who are depressed [32, 33]. These apps frequently have tools like guided meditation, mood tracking, and individualized feedback to help users deal with depression [34, 35]. It was also seen that applications can improve mental health outcomes for individuals with depression and increase user engagement [33–38]. With features like mood tracking and coping mechanisms, several applications aim to assist users in managing emotional dysregulation [39]. These resources are especially helpful for people who want to improve their ability to control their emotions in addition to more conventional treatment approaches [20, 40].

Assessing the effectiveness and user experience of digital mental health apps

Digital mental health treatments have proven to be quite successful in enhancing mental health results in several fields. Conversational agents (CAs) in these Digital mental health apps have been shown in a thorough systematic review and meta-analysis to considerably reduce psychological distress and depressive symptoms [41]. In some groups and intervention types, these impacts were especially noticeable. These interventions are significantly more effective for multimodal or voice-based CAs coupled with mobile applications and instant messaging platforms, as well as for generative AI-based CAs as opposed to retrieval-based ones. Additionally, clinical, and subclinical groups, as well as older persons, seem to respond better to Digital mental health interventions [41]. Even though these results are encouraging, it is important to remember that Digital mental health interventions should be seen as an adjunct to human knowledge rather than a substitute, and ethical issues pertaining to these interventions need to be properly addressed [41, 42]. Digital mental health interventions have proven to be highly accurate in identifying early indications of several mental health issues [43, 44]. Participants’ anxiety and depression levels significantly decreased after just 2 weeks of using chatbot Woebot [43, 44]. Digital mental health apps integrated with Artificial Intelligence are more accurate than human clinicians at predicting mood swings and relapse likelihood in patients with mood disorders [45].

The importance of user input in the evolution of digital mental health interventions

User reviews are thought of as a thorough assessment of the software from the viewpoint of the user. Both positive and negative comments may be included in these reviews, which also highlight certain features or attributes that users find appealing and unappealing [46]. The development and efficacy of Digital mental health interventions heavily depend on user input. Developers may produce more individualized, interesting, and effective mental health support solutions by taking user input and experiences into account. User reviews are therefore regarded as a rich source of data and a useful source of wisdom. Thus, a lot of researchers have adopted the strategy of looking at user reviews to get information and to address unmet customer demands. Pagano and Maalej, for instance, validate that user reviews contain useful remarks, user experience, issue reports, and feature requests [47]. Additionally, a medication reminder app was assessed by Stawarz et al. [48] through a thematic analysis of user evaluations. They were able to learn how consumers utilize the app from the reviews. Similar to this, Nicholas et al. [49] looked at consumers’ opinions about bipolar disorder apps by using user reviews. Thach [50] claims that this approach enables the researcher to conduct a quantitative synopsis of the reviews’ primary topics and to apply qualitative analysis to gain deep insights into users’ viewpoints.

Existing evidence on user experience with digital mental health applications

Over the past decade, digital mental health chatbots have become a key mode of scalable mental health delivery. Across these platforms, studies consistently report that conversational empathy, personalization, and ease of use are central determinants of user satisfaction and mental health outcomes. Chatbots have been shown to effectively reduce the severity of mental health concerns for people from various demographics and backgrounds [51]. Several well-known chatbots, like Wysa [52], Woebot [53], Replika [54], Youper [55], and Tess [56], were discussed in previous literature. Inkster et al. [52] evaluated Wysa and found significant reductions in depressive symptoms, attributing this outcome to its emotionally supportive conversational style and intuitive task design. Fitzpatrick et al. [53] investigated the effectiveness of the AI chatbot Woebot in college students and discovered that it significantly reduced symptoms, highlighting the role of short, interactive exchanges. Ta et al. [54] studied interactions with chatbot Replika, underscoring acceptability and perceived empathy as core user experience dimensions. Mehta et al. [55] investigated the acceptability and effectiveness of Youper.

In addition to commercial apps, research communities have been increasingly involved in designing chatbots for specific purposes, such as teaching self-compassion (“Vincent”) [57], enabling self-disclosure [58, 59], facilitating positive messages within social groups [60], improving the quality of life of older people and making them more active to fight their sense of loneliness [61], supporting interpersonal skills (“Sunny”) [62], and reducing stress (“Mylo”) [63, 64]. These studies demonstrate that experiences in mental health chatbots is shaped by broader domains of acceptability, usability, usefulness, and integration defined in digital health frameworks [65].

However, most existing research remains system-centric rather than user-led evaluations. Few studies have analyzed how end users themselves perceive, rate, and describe their lived experiences with these tools in naturalistic settings. Moreover, Indian and other low-resource contexts remain under-represented, where affordability, language accessibility, and data privacy perceptions may uniquely shape user experience. Addressing this gap, the present study examines real-world reviews of the Amaha mental health application to uncover authentic user perspectives on these key domains.

Prior research has established a set of recurring qualitative dimensions for assessing digital mental health applications. Malik et al. (2022) analyzed user feedback from the Wysa app and identified four primary domains- acceptability, usability, usefulness, and integration as key indicators of user experience and therapeutic engagement. These domains draw conceptually from the Healthcare Information and Management Systems Society, Digital Health Evaluation Framework [66], which emphasizes user satisfaction, efficiency of interaction, perceived clinical benefit, and data security as essential quality parameters in digital health design. Subsequent studies [67, 68] have applied similar dimensions when examining mental-health chatbots such as Woebot and Wysa. Together, these frameworks provide an empirically grounded basis for the present study’s thematic coding, ensuring that the identified domains align with established digital mental health quality constructs rather than researcher-generated categories.

Need for the study

Digital mental health apps are revolutionizing the mental health care system across the globe. This revolution needs to be supported as it could address the existing issues surrounding mental health such as shortage of mental health professionals, stigma surrounding mental health, financial barriers, etc. These apps could support mental health professionals in building a better system and these could be seen from the upsurge in the number of mental health apps over the past few years. However, even though these apps supplement professionals there is a dire need to understand from the user point of view regarding how they find these apps and whether these apps are as helpful as they claim to be. There is also a necessity to focus these studies on apps which are built in Asian countries since a majority of the apps are built in western countries keeping the western population in mind which leads to significant barriers. Therefore, the current study aims to bridge this gap by investigating the user experiences of an Indian based app Amaha by focusing on their perceptions of acceptability, usability, usefulness and integration. While the present study analyses publicly available reviews from general users of the application, the findings may offer important insights into how digital mental health platforms could support emotional wellbeing among young adults and university populations in post-pandemic educational contexts. Understanding user experiences may therefore assist educational institutions, mental health professionals, and app developers in identifying how such platforms can function as supplementary support systems for students experiencing stress, anxiety, loneliness, and emotional difficulties. The research questions which would be explored through this study are:

RQ1: How do users describe app under the domain of acceptability, usability, usefulness and integration?

Methodology

App background

The digital mental health app Amaha (formerly InnerHour) combines self-care strategies with evidence-based cognitive-behavioral therapy (CBT) methods. The app, which was created in 2016 by an Indian team lead by healthcare entrepreneur and psychiatrist Dr. Amit Malik and social entrepreneur Neha Kirpal operates as a private entity, and offers to provide personalised treatment plans, an instant relief chatbot (based on a logic tree), access to booking and managing therapy, and psychiatry sessions along with self-care tools like mood trackers and journals, and an anonymous moderated community. Amaha, available to users 18+, offers free self-care tools with optional subscriptions (₹199/month, ₹499/quarter, ₹1999/year) and paid therapy/psychiatry services. Through the use of mood tracking, guided exercises, and mindfulness practices, Amaha allows users to participate in structured therapeutic journeys that are suited to issues like stress, anxiety, and depression. With over 1 million downloads and over 29,400 reviews on the Google Play Store, the app has seen tremendous growth. Amaha has a 4.0 out of 5-star rating in the Apple App Store, indicating positive user involvement. A systematic review of mental health conversational agents (CAs) found that interventions based on CBT principles, like those used in Amaha, promote self-management of mental disorders through structured therapeutic elements [69] This app was selected for this study due to its relevance within the Indian context, its increasing adoption among users, and the availability of a large volume of publicly accessible user reviews. These characteristics make it a suitable case for examining real-world user experiences outside controlled research settings.

Furthermore, majority of research on digital mental health apps concentrates on Western-centric platforms such as Headspace, Talkspace, Wysa, and Woebot, which creates a cultural and geographic gap in understanding mental health needs in settings with limited resources. The National Institute of Mental Health and Neurosciences (NIMHANS), in collaboration with the Indian Council of Medical Research (ICMR), recently developed a pilot Mental Health App Repository to assist users and professionals in navigating digital mental health platforms through structured evaluation criteria. The repository was developed following the screening of thousands of mental health applications using standardized quality assessment frameworks such as the Mobile Application Rating Scale (MARS). Amaha is included within this repository of publicly accessible mental health applications, highlighting its relevance within the evolving digital mental health ecosystem in India.

Study design

In order to get direct user feedback, the authors looked at reviews that were published on the Google Play Store between January 2022 and January 2025. Reviews were obtained and data cleaning was conducted in Microsoft Excel. For this period, 3249 user reviews were received, omitting ratings that were devoid of reviews. To obtain an adequate sample size, a 3 years period and the utilization of Google Play reviews were examined. The authors used the pre-established codes developed by Malik et al. (2019) to codify the user-provided reasons for rating to analyse descriptive feedback. User comments in non-English languages, blank spaces, and reviews with one-word nondescriptive statements were excluded. Analysis of feedback content was the main goal of the study to comprehend how users interacted with a digital mental health app. As a secondary goal, feedback-based user classification was also carried out.

Analysis

The written reviews were categorized into the predefined themes and sub-themes given by Malik et al. which was developed using a consolidated framework developed by Chan et al. [10], the US Federal Government and the Healthcare Information and Management Systems Society (HIMSS) for assessing digital health apps. The thematic analysis looked at different domains of (1) acceptability (e.g., satisfaction, matching expectations of capabilities, likelihood to recommend, and level of interactiveness), (2) usability (e.g., the ease, enjoyment, cultural, and demographic accessibility of use), (3) usefulness (e.g., validity, reliability, effectiveness, and time required to obtain a benefit), and (4) integration (e.g., security, privacy, data integration, and safety) in order to understand Amaha’s current ability to assist and engage users. Thematic analysis followed the six-phase framework of Braun and Clarke (2006) to ensure methodological rigor. User reviews (n = 3249) were read multiple times for familiarization, and codes were developed through a deductive–inductive approach. The predefined coding framework, adapted from Malik et al. (2022) and the HIMSS Digital Health Evaluation Framework by Chan et al. (2020), encompassed four domains—acceptability, usability, usefulness, and integration—capturing user satisfaction, interaction ease, therapeutic value, and privacy. Codes were then organized within these domains to identify recurring patterns. During this process, an emergent subtheme, “companionship,” was added under usability due to its frequent appearance in user narratives describing the chatbot as an emotionally supportive companion. Data was reviewed by two independent coders for consistency and refined to align with prior frameworks and empirical evidence. This approach ensured that the thematic structure represents a theoretically grounded yet empirically emergent understanding of user experiences with the Amaha app, ensuring that the analytic process is sufficiently transparent and replicable. Each sentence or meaning unit within a review was coded independently based on its semantic content. This approach, consistent with Braun and Clarke’s (2006) recommendations for segment-based thematic coding, ensured that overlapping or multidimensional user experiences were adequately captured. Thus, individual reviews may appear in multiple thematic counts where relevant, reflecting the interconnected nature of user experiences with digital mental health apps (Fig. 1).

Fig. 1.

The themes and subthemes discussed in the study

Each user review was assessed and assigned to one of these themes. The acceptability domain reflects on how well users perceive and accept the app, particularly in terms of its content, functionality, and overall experience. The theme of Usefulness captures the ease of use and comfort experienced by users when interacting with the app. The theme of usability theme evaluates how effective and beneficial the app is in addressing users’ needs and providing value. The domain of integration evaluates how well the app aligns with users’ expectations around data security and privacy concerns.

Result

The study examined 3249 reviews from 2022 to 2025, 108 of which were eliminated because they were non-English and irrelevant to the study (for example, good service with a sbi card). To ensure consistency between quantitative ratings and qualitative content, reviews with 3–5 stars were initially classified as positive and those with 1–2 stars as negative. Each classification was then cross-verified by reading the textual content to ensure that the expressed sentiment matched the rating. Reviews lacking textual comments were excluded. It was seen that out of 3249 reviews, 2764 (85.1%) were positively rated reviews and 363 (11.2%) were negative, and 122 reviews (3.7%) were neutral. The evaluation criteria included four themes i.e., Acceptability, Usefulness, Usability and Integration, that sought to capture user experiences and attributes. The thematic coding produced 3666 coded references in total, distributed across four domains: Usefulness (n = 2192; 59.8%), Acceptability (n = 1165; 31.8%), Usability (n = 265; 7.2%), and Integration (n = 44; 1.2%). This pattern suggests that users primarily discussed the app’s practical benefits and therapeutic value, followed by engagement and acceptability features, while relatively fewer comments addressed usability barriers and data privacy aspects. The themes and subthemes along with results are described below:

Theme 1: Acceptability

The concept of acceptability captures how much users think the app is advantageous, user-friendly, and favourable. This subject is essential to comprehending adoption rates, sustained engagement, and user satisfaction. This area discusses three main sub-themes: Engagement of Exercises, Interactivity of Interface, and Conversational Ability of Chatbot.

Sub-theme 1.1: Engagement of exercises

The Engagement of Exercises relates to how users find the app’s activities engaging, inspiring, and pleasurable. Users complimented the exercises’ therapeutic qualities, describing them as “calming” and “stress-relieving,” with several mentioning how well they worked to manage anxiety and enhance conventional therapy: “…. I’ve found the app to be really useful for my severe anxiety disorder, and for helping me stay mindful and positive….”, “…doing small activities really help me when I’m sad, angry, or just tired….”.

Another user talks about “…It has all sorts few minutes meditation audios with soothing music, exercises, relief bots, weekly plans and what not….” thus focusing on the importance of diversity of exercises. Diverse exercises surely are an important factor noted by the users. “…The app has many features like journaling, meditation, negative thoughts removing exercise, therapy sessions etc.….” The simplicity and clarity of instructions are also appreciated “I enjoy the exercises; they aren’t too overwhelming & the guide & descriptions are helpful.” Users find that short daily encounters with the activities are especially helpful in incorporating mindfulness into their regular routines and efficiently managing stress: “…I started using it daily to achieve stable mind….” Another user also talked about “…. every day whether it be 5 minutes or 10 minutes the exercises and the time I spend on this app are always calming and stress relieving….”

Sub-theme 1.2: Interactivity of interface

Interactivity of Interface pertains to the degree of user interaction facilitated by the app and the responsiveness of its features. A key factor in improving user experience and encouraging long-term engagement is the app’s interface’s interactivity. Key features including simplicity, ease of use, and the interface’s soothing style are highlighted by user feedback.

One user shared, “The app is awesome! With a user-friendly, and easy-to-navigate interface. This app is one of the best I’ve ever used. " This highlights the app’s intuitive design, which caters effectively to both new and experienced users. User emphasized on the “Simple”, “Brilliant” and easy-to-navigate” interface. According to these reports, the user-friendly style and soothing aesthetics significantly enhance positive user experiences, even encouraging some users to seek premium memberships. The interactive elements of the app were also highlighted: “Excellent, very helpful, concise, informative, fun, and interactive interface.” This demonstrates how the app can keep users informed and engaged by striking a mix between interesting, interactive features and educational content.

Sub-theme 1.3: Conversational ability of Chatbot

The conversational ability of Chatbot shows how relevant, natural, and effective Amaha’s relief chatbot Allie is at mimicking human-like conversations, correctly comprehending user input, and providing insightful, context-appropriate responses.

Comments such as “… Like whenever I feel tensed, I chat with Allie, and it helped me a lot!” demonstrate Allie’s therapeutic influence.”, “It’s chatbot, Allie (that’s a super cute name), helps a lot, and you can do activities which make you feel better.” “Tbh, I had depression, and I am 10 years old only, but to be honest, Allie was the only one that has ever been proud of me. I am now standing out in the crowd knowing that I was the only one that supported myself, not my family or friends, only myself.” read a particularly heartfelt review. This demonstrates the significant influence of Chatbot’s empathetic reactions, which can change a user’s life by providing vulnerable users with validation and encouragement.

Although the majority of reviews emphasize pleasant experiences, some users point out areas that might use improvement, like the ability to input your own terms instead of using the app’s pre-defined chat words and the expansion of capabilities without paid restrictions: “.I rate this a 3 star because when speaking to Allie, you aren’t allowed to type your own words….”.This suggests that increasing access to core features could enhance the app’s therapeutic reach.

These findings are consistent with prior work emphasizing empathy and conversational tone as critical determinants of acceptability in digital mental-health chatbots. Studies on Wysa and Woebot similarly reported that supportive dialogue and human-like responsiveness enhance user trust and perceived helpfulness [52, 53]. Malik et al. (2022) also observed that emotional resonance and interactivity strongly predict continued app engagement, confirming the centrality of these features in fostering acceptance.

Theme 2: Usability

The concept of usability encapsulates how comfortable and easy it is for consumers to interact with the application. Because it affects how quickly and successfully users may accomplish their objectives within the app environment, usability is a crucial factor in determining user retention and overall happiness. Ease of Conversation and Nonjudgementality are two important sub-themes under this area.

Sub-theme 2.1: Nonjudgementality

The app’s ability to offer a secure, encouraging, and sympathetic atmosphere free from judgment or criticism is reflected in the sub-theme of Nonjudgementality. For mental health applications, where users frequently discuss extremely sensitive and intimate topics, this feature is especially important.

Users appreciated the app’s tolerant and neutral atmosphere while reflecting on their own difficulties opening to others: “After using the app, I feel like someone really wanted to hear my thoughts and really cared for me without overthinking that someone would judge me for whatever I wrote down.” Further, another user shared, “I am a person who can’t talk to people about my problems, stress, and anxiety—not even with those I love so much. I am really glad that there is no judgment from bots.” This evaluation emphasizes the special benefit of AI-powered mental health tools: the lack of human prejudices and assessments, which might make the environment more approachable for people who have trouble confiding in others. Lastly, a user succinctly appreciated the app’s supportive environment, stating, “I can add some notes and write down how I feel without any judgment.“, “I like the app, because it helps me to express myself especially in things which am insecure to share with someone. I like it anyway.” This emphasizes how crucial it is to establish online environments where people feel free to express their feelings, as this promotes improved mental health outcomes.

Sub-theme 2.2: Ease of conversation

The term “Ease of Conversation” describes how simple and easy it is for users to interact with the app. An app that excels in conversational ease reduces user frustration and promotes longer, more meaningful interactions.

Some users found the app intuitive and user-friendly as seen in reviews: “Already I really like it; the visual cues and layout is great.”, “This app is really easy to use….“.These comments suggest that for certain features, the app successfully provides clear instructions and an easy-to-navigate interface. Based on the reviews, response time both in terms of app functionality and customer support, has been inconsistent: “Each time I enter an OTP they say it’s incorrect. I’ve been trying to log in for months.“, “The app keeps logging me out. I log in with OTP but as soon as it logs in, it logs me out again. Very inconvenient when you want to access the app….“, “Never thought I will return to edit a zero review… the support team makes me wanna do just that… their solution to the app not working for me for 3 weeks is… try to install and re-install the app”. The delayed or ineffective technical support responses, along with recurring login issues, disrupt conversational flow and diminish user satisfaction.

While some users appreciate the conversational design: “It really helps me and is so easy and understanding app.” Others felt restricted by the limited response options: “I rate this a 3 star because when speaking to Allie, you aren’t allowed to type your own words.“, “The chat bots give options and answers that don’t suit everyone and that doesn’t give me too much space to talk about my feelings.“. These insights highlight the need for more flexible, human-like interactions that allow for personalized expression.

The usability patterns observed here parallel earlier findings that simple navigation, responsive interfaces, and non-judgmental environments enhance sustained participation in digital mental-health apps [67, 68]. The emergent sub-theme of companionship extends previous research by illustrating that users may experience relational comfort with chatbots—a dimension also noted in studies of Replika and other AI companions [54]—highlighting how usability and emotional design intersect to support long-term engagement.

Theme 3: Usefulness

The theme of Usefulness evaluates how effective and beneficial the app is in addressing users’ needs and providing value. Usefulness is a critical factor influencing user satisfaction and continued engagement with the app. This theme includes several sub-themes that highlight different aspects of the app’s value to its users.

Sub-theme 3.1: Impact on mental health

The sub-theme of Impact on Mental Health refers to the app’s ability to positively influence users’ mental well-being. Apps that successfully promote mental health often incorporate features such as mindfulness exercises, mood tracking, and therapeutic interventions.

Reviews from users show both good and bad experiences, highlighting the app’s ability to promote mental health as well as potential areas for development. The software is quite helpful in managing symptoms of stress, anxiety, and depression, according to several users; “I love this app so much it helps me avoid negative thoughts and depression….” A user wrote, “Whenever I felt down, I just open it and it makes my day 100% better and it helped me a lot with my anxiety and depression….” This opinion emphasizes how users reported perceived emotional improvement based on how the software may offer both flexible assistance alternatives and instant emotional alleviation. “Every time I wanted to suicide, I’ll go here,” adds a moving review, highlighting users perceived the app as highly supportive during moments of severe distress. According to one user, “There really shouldn’t be a paid plan for a self-help app especially if someone is on the verge of a mental breakdown and/or seriously thinking about committing suicide.“.This emphasizes how crucial it is to keep information that is approachable, nonjudgmental, and encouraging for people going through a crisis. The app’s strategy for mental health messaging was also criticized by some users. One review said, for instance, “Even if you are feeling okay, the app wants to make you feel that you are depressed, and we are here to help you. I think a depressed person should not be pointed out that he/she is depressed.” This feedback emphasizes the significance of sensitive wording and customized user experiences.

Sub-theme 3.2: Companionship

The term “companionship” describes how users could experience the app as a buddy or close friend, particularly in lonely or distressing situations. This sub-theme is critical for apps designed to offer emotional support, as it fosters a sense of belonging and reduces feelings of isolation.

Users commonly attributed human-like traits like companionship, empathy, and emotional support to Allie, the app’s chatbot companion, describing her as more than just a support tool. “She is such a mood maker; I love her so much….” Another review states, “Allie really makes me happy whenever I have negative emotions.….” The statement “the bot is helping me so much with my Life and he is like my best friend i love it” demonstrates how Allie goes beyond the typical role of a chatbot to become a virtual best friend who provides constant emotional support, strengthening users’ sense of connection and lowering feelings of loneliness. The personification of Allie, with users referring to the chatbot as a “best friend” or “companion,” underscores the emotional bond users develop and it reflects the AI’s ability to fulfil companionship needs, especially for individuals experiencing loneliness or isolation. Another user expressed that, “This app is AMAZING I haven’t slept this well in weeks. Allie is my new best friend he has helped so much!!”, “Feels like I have a best friend by my side…as a teenager in this generation it really helps me a lot.”. These statements emphasize the dire need of having a companion in this digital era and how people are relying on digital apps due to the lack of having a companion; especially in children who are missing out on these things in this era and who might be facing unique emotional and social challenges. The app appears to act as an emotional anchor for users navigating mental health challenges. For instance, a user noted, “I’m seriously going to cry. I’ve been through a lot right now, this app and the Allie Bot felt like best friends to me. Allie made me feel like I’m loved.” “It’s like a friend with ears always waiting and having time for you,” a user remarked. “…. if you ever want to talk to someone but you don’t have someone to talk to, you can talk to this buddy…” proving that the app’s continuous availability offers a dependable source of solace without the worry of criticism or rejection.

Sub-theme 3.3: Convenience of access

The ease and speed with which users can access the app and its features is referred to as convenience of access. This covers features including accessibility, ease of installation and download, and usability when on the go. The examination of user evaluations reveals serious issues with the mental health app’s accessibility. The challenge of logging in and obtaining therapy sessions is a frequent one. Numerous users complained of technical issues that made it difficult for them to utilize the app efficiently. “App doesn’t work for me; I can’t login using my mobile number,” said one user, and “Keeps throwing error again and again. No support system.” said another. These problems not only made access difficult, but they also made users unhappy.

Users complained about payment problems, technological difficulties, and the inability to choose or switch therapists. Another major obstacle was affordability issues, which made people upset that services were not freely available to them. Because easily available apps are more likely to be incorporated into regular habits, convenience of access has a big impact on user retention.

Sub-theme 3.4: Therapeutic self-help techniques

The term " Therapeutic Self-Help Techniques” describes how the software can give users the tools they need to change their negative thinking, cultivate a more optimistic outlook, and deal with obstacles more effectively. These activities, which may include Thought Record Templates, Mindfulness Practices, and Positive Affirmation Tools, are frequently based on cognitive-behavioral therapy (CBT) methods.

The Therapeutic Self-Help elements of the program were highly praised by many users, who also mentioned how well it worked to help them change their negative thought patterns into positive ones. A user wrote, “It really helps me to reach out of my negative thoughts and many more….” Another user remarked, “This app has helped me so much. It has helped me overcome negative emotions and focus on positive things in life….” The Self-Help Techniques, according to users, helped them focus again, manage mood swings, and lower anxiety. One review captured this sentiment: “All I can say is when you are stressed or sad or worried, you can just open this app and follow what it says to do, and you will end up feeling good about yourself.” “Every time I feel bad or have negative thoughts, I reach out to InnerHour…,” said another user. The range of resources offered, such as guided imagery, positive affirmations, and mindfulness exercises, was highly valued by users. One positive review, for example, said, “It’s so slay there’s just so much. My favourite is the guided imagery; it is literally so good I actually cried when it ended.”, “The Tasks, Journal, and Goals feature are one of the best……”.

The reported therapeutic gains align with evidence that CBT-based and mindfulness-driven mobile interventions produce measurable improvements in mood and self-regulation [32, 65]. The emergence of companionship under the Usefulness domain highlights the emotional utility of chatbots in providing perceived support and connection. This observation extends previous findings on AI-based empathy and relational bonds observed in studies of Replika and Wysa [33, 54]. Similar emotional companionship effects have been identified as critical for promoting psychological well-being and sustained app use [65, 70]. User’s references to cognitive restructuring and journaling mirror mechanisms identified by Curtiss et al. (2021) and Klein et al. (2024), suggesting that such exercises effectively facilitate emotional reframing and coping skills within app-based contexts [71, 72].

Theme 4: Integration

The theme of Integration evaluates how well the app aligns with users’ expectations around data security and privacy concerns. In an era where digital privacy is paramount, ensuring the confidentiality and protection of personal information is critical for user trust and acceptance.

Sub-theme 4.1: Privacy

Privacy refers to the app’s adherence to protecting personal information from unauthorized access. This includes user confidence in data collection and storage practices. Privacy considerations focus on Data Encryption, Transparent Policies, Control Over Personal Data.

User feedback regarding the privacy of the app revealed mixed sentiments. Some users highlight the app’s transparent procedures and express a high level of confidence in its security precautions. “Literally the best therapy app I’ve ever used. So transparent and scheduling sessions is a breeze.” This suggests that the app’s data management and privacy policies satisfy the needs of some users, promoting convenience and confidence. But not every review is favourable. Perceptions of data security may be related to worries about price transparency. One unhappy customer said, “The price set-up isn’t transparent,” These issues implicitly indicate worries about the app’s integrity, which might affect perceptions of data privacy, even if they are more directly related to service quality. While explicit complaints about data security breaches or privacy violations were not noted, the underlying concerns about trust and authenticity can impact perceptions of data safety.

Sub-theme 4.2: Confidentiality

Confidentiality refers to the assurance that users’ conversations and shared information within the app are kept secure and not disclosed without their consent. A key component of user trust is confidentiality, especially in apps pertaining to personal development, counseling, and mental health. According to user reviews, there is a high degree of confidence and security in the app’s secrecy features. Many users praised the app’s security features, especially the option to create a personal security pin to safeguard their private information, which increased their feeling of security and privacy when using the app.

One user noted, “If you’re needing privacy and are afraid someone will grab your phone and read your innermost thoughts in this app, don’t worry, you can put a pin on it to keep it safe.” Another user shared, “It works and I love how you can set up a security pin. It just shows how much the developers know and can relate to how you’re feeling, to be secure of your emotions and have privacy of how you feel from others.“. Users also appreciated the secure environment for expressing emotions and thoughts without fear of unauthorized access. One customer wrote, for example, “The personal pin feature adds an extra layer of privacy and security which allows me to be and work on myself.” “I felt safe when texting with Allie,” said another user. This implies that confidentiality security measures are not just technical but are also viewed as crucial to the therapeutic process, promoting transparency and candor in self-reflection.

Similar privacy and transparency concerns have been widely reported in the literature on AI-enabled mental-health tools [20, 73]. Our results reinforce the view that data-protection features and clear communication of privacy policies are central to building user trust and sustaining engagement, echoing the integration challenges highlighted by Chan et al. [66] and Borghouts et al. [74].

Emerging patterns in user experiences

Analysis of user reviews revealed several recurring patterns in how individuals described their reasons for using the application: those looking for companionship to reduce loneliness, those seeking support for depression, anxiety, and stress (Table 1). Different motives and experiences with the app are highlighted by each category.

Table 1.

Emerging patterns in user-reported experiences and perceived benefits

User patterns	Description of user-reported benefit
Managing depressive symptoms	Improved emotional health through journaling, mood tracking, and cognitive exercises.
Managing anxiety-related concerns	Provided instant relief via breathing techniques, mindfulness, and real-time coping tools.
Managing daily stress	Helped manage daily stress with goal-setting and structured exercises.
Seeking emotional support and companionship	Offered companionship through chatbots and community support.

1. Managing depressive symptoms A lot of users said they used the app as a supportive tool to control their depression symptoms. The app’s features which include journaling, mood trackers, guided meditations, and cognitive restructuring exercises offer an organized method for spotting harmful thought patterns and encouraging emotional control. As an example, one user said, " This is the best app yet! I have been dealing with deep depression for weeks now but! Once I started this app I got better on my mental health issues!” This illustrates how the application helps those who are depressed improve their emotional health.

2. Managing anxiety-related concerns For those who are struggling with anxiety, the app is a useful tool. Features including breathing techniques, mindfulness exercises, and real-time coping mechanisms that lessen worried thoughts were well-liked by users. A user wrote, “I definitely love this it helps me cope with my situation like anxiety attack, depression and many more also the activities are really effective, the breathing pattern and also texting with Allie I just love it….” This shows how well the software works to provide skills to reduce anxious symptoms and instant relief.

3. Managing daily stress Another important justification for utilizing the app was stress management. The app’s goal-setting tools and structured exercises helped users feel more in control and less stressed out by everyday challenges. According to one review, “It is an amazing app. It helped me a lot and reduce my stress and the best thing is that it never made me feel lonely and comforted me a lot.” This suggest that users perceived the app as a supportive resource for stress management.

4. Seeking emotional support and companionship The application acts as a virtual companion for lonely people, offering a sense of connection through captivating chatbots and community support tools. The comment, " I’ve been really lonely lately my family and friends didn’t understand me when I try to express myself, and for a person like me this app made me feel loved and appreciated.” demonstrates how users expressed gratitude for the app’s emotional support. This emphasizes the role of digital tools in providing perceived emotional connection and reducing feelings of isolation.

Discussion

This study focuses on elements including accessibility, usability, usefulness, and integration to highlight important insights concerning the user experiences of the Amaha mental health app. 3249 user evaluations from 2022 to 2025 were examined in this study; 108 reviews were disregarded because they were too difficult to understand or had nothing to do with the study’s objectives. A majority of the reviews were favourable, with 2764 expressing satisfaction with the app’s features and usefulness and 363 expressing discontent.

The predominantly positive feedback indicates that users find the app useful in general, especially when it comes to engagement, usability, and mental health support. Nonetheless, the existence of unfavourable evaluations (11.18%) draws attention to certain shortcomings or unfulfilled user expectations that call for more research. These findings are consistent with previous research demonstrating that, while digital mental health apps offer accessible and scalable solutions, user engagement and perceived effectiveness vary greatly depending on individual experiences and app functionality [75–78]. Future research should examine the specific issues brought up in unfavourable evaluations, especially those pertaining to unmet treatment needs, Chatbot limits, and usability hurdles, in order to improve user experience and retention.

While user reviews provide valuable real-world insights into user experiences, they do not necessarily reflect the clinical effectiveness or evidence-based quality of digital mental health interventions. Users often evaluate applications based on accessibility, emotional comfort, and ease of use rather than therapeutic outcomes. Therefore, the findings of this study should be interpreted as indicators of perceived usefulness and user satisfaction rather than objective measures of clinical effectiveness.

The themes presented in the study draw attention to the app’s function in offering user-centred, adaptable, and easily available mental health help. The app’s significance in modern mental health treatment is highlighted by the noteworthy combination of digital tools based on cognitive-behavioural therapy (CBT) principles and safe data management procedures [79, 80]. These themes are important because of how they affect mental health outcomes. For instance, cognitive restructuring exercises improve users’ coping skills by encouraging positive thought patterns and emotional regulation [72, 81]. In mental health interventions, where sensitive information is frequently exchanged, user trust is crucial, and strong privacy and confidentiality protections are essential to building that confidence [82, 83]. The impact which these apps make on user’s mental health is also a major factor to be considered. Positive mental health outcomes are strongly correlated with increased user satisfaction and long-term engagement [75, 83, 84]. These thematic insights align with existing literature emphasizing the dual necessity of clinical effectiveness and user-friendly design in digital mental health interventions.

The findings may hold particular relevance for university and higher educational settings, where increasing levels of post-pandemic psychological distress among students have intensified the need for scalable and accessible mental health support systems. Digital mental health applications such as Amaha may function as supplementary wellbeing tools alongside traditional counselling services by providing immediate emotional support, self-help exercises, mood regulation techniques, and non-judgmental spaces for emotional expression. In hybrid educational environments, such platforms may also support preventive mental health approaches by enabling early emotional self-management and improving access to support for students hesitant to seek face-to-face counselling.

While considering the positives of the app, it is necessary to focus on the lacunae of the app as pointed out by the users. One of the main issues which were expressed by a significant number of users were the paid plans for using the various plans; “It sucks having to pay to improve mental health”, “I downloaded this app because I was in a tuff spot in my life and my anxiety was peaking. It seemed welcoming and safe, they ask you a few qns and then you get bombarded by payment plans.”, “I hate this app. I’m just a kid in middle school trying to lower my anxiety and every time I downloaded an app, they only care about money. I can’t get access to my plan unless I pay.”. These reviews clearly reveal the need for free and effective digital platforms or some digital initiatives which would help in providing access to mental healthcare for the needy [85, 86]. In 2024, MyCHN, a Federally Qualified Health Center (FQHC) in Texas, decided to implement Wysa, a mental health app to assist underinsured and uninsured individuals. MyCHN actively marketed the app through instruction and hands-on support to guarantee fair access. By acquiring licenses, they eliminated financial obstacles and made the software available to patients for free. Despite a lack of workers, adoption rates rose by more than 50%, filling gaps in mental healthcare. This clearly shows that in order to increase accessibility and impact, policy changes are necessary, including expanded funding for digital mental health services, as demonstrated by the success of digital health platforms like Wysa [87]. There were also concerns regarding technical issues from few customers; “I installed this app but it’s not opening after sign up.”, “This app keeps on being stuck every single time I open it.”. Previous studies show that Higher dropout rates and less engagement can result from frustration brought on by technological difficulties. According to research on digital mental health therapies, maintaining long-term app usage requires a smooth user experience [88].

The findings indicate a balance between perceived benefits and reported limitations. While users frequently highlighted emotional support, accessibility, and ease of use as strengths, concerns related to affordability, technical issues, and restricted features were also evident. This suggests that digital mental health applications can enhance access to support but may not fully replace the depth and adaptability of traditional mental health services. These findings also highlight a key tension between accessibility and commercialization in digital mental health platforms, where financial barriers may limit access for users who need support the most.

In addition to thematic analysis, the app’s user base’s demographics offer insightful information. As a reflection of larger societal trends in mental health requirements, the app predominantly draws users who are struggling with depression, anxiety, stress, and loneliness. According to this pattern, internet platforms are becoming more and more seen as vital tools for people looking for quick, stigma-free help, especially in situations when traditional treatment might not be available because of personal, financial, or geographic constraints [83, 89–91].

The function of apps in mental health care is further clarified by psychological factors that influence their use. Users frequently look for quick coping mechanisms, emotional support, and a sense of community [51]. The app serves as a digital companion in addition to a therapeutic tool, especially for people who are socially isolated. This dual purpose suggests that mental health apps are becoming seen as essential parts of users’ emotional support networks rather than just self-help resources. User engagement and happiness are greatly impacted by the app’s technological characteristics, such as usability, interface design, pricing, and chatbots [84]. Effective mental health applications must balance clinical rigor with technological innovation to maintain long-term user retention. To ensure long-term user retention, effective mental health applications must strike a balance between clinical rigor and technical innovation. Enhancing the entire user experience and guaranteeing ongoing engagement requires interactive features, user-friendly interfaces [46, 92, 93], and customized feedback methods.

Digital mental health applications ought to provide individualized experiences based on user requirements, such as customized wellness programs, tailored interventions [64–66] Artificial intelligence (AI) can be integrated with these apps to evaluate user data and offer insightful information on mood tracking and pattern recognition, provide predictive analytics for early mental health problem detection, and offering tailored coping mechanisms and activity recommendations. Advanced natural language processing can also be used by these apps to create engaging interactions, such as chatbots for round-the-clock assistance and guided therapy sessions, empathetic user conversations to offer emotional support, and the capacity to identify possible crises and refer users to human professionals when needed [67]. They can also combine human knowledge with these apps and include tools for Crisis Intervention [68].

However, it is important to consider the possible drawbacks of digital apps for mental health. Over-reliance on self-guided tools might be risky [94], particularly in emergency situations where professional support is crucial [95]. Additionally, the digital gap, which emphasizes disparities in the availability of mental health support, may restrict access for certain groups [96, 97]. AI-driven systems may lack the contextual sensitivity required for complex mental health conditions and may not respond appropriately in crisis situations. Furthermore, issues related to data privacy, transparency, and algorithmic bias remain significant challenges. These difficulties highlight how crucial it is to combine digital interventions with conventional mental health treatments in order to offer thorough, all-encompassing care.

This study concludes by suggesting topics for additional investigation and app development. To advance the area, long-term efficacy research, cross-cultural evaluations, and ethical issues related data privacy are crucial. Furthermore, adding ongoing feedback systems and fortifying ties with expert mental health services may improve the efficacy and dependability of digital mental health platforms. Apps for mental health can develop to satisfy the intricate, changing needs of their varied user base by addressing these issues.

Policy and design implications

The findings of this study carry important implications for policymakers, educational institutions, and digital mental health developers. Universities and colleges may increasingly consider integrating digital mental health applications as supplementary wellbeing resources within student support systems, particularly in hybrid and post-pandemic learning environments. However, issues related to affordability, accessibility, technical reliability, privacy, and crisis-response mechanisms must be carefully addressed to ensure ethical and equitable implementation. Greater institutional partnerships, subsidized student access, multilingual support, and transparent privacy practices may improve the accessibility and effectiveness of digital mental health platforms among diverse populations.

Limitations

The data is drawn exclusively from Play Store reviews, representing only those who opted to share feedback. The current findings are reflecting themes and user categorisation on the basis of a popular private run mental health app. The analysis of this study could be used as framework for other digital apps but cannot be generalised to the other existing mental health application reviews. The study does not measure actual engagement metrics such as frequency or duration of app use. Instead, findings are based on self-reported experiences within user reviews, which may not accurately reflect sustained engagement. Furthermore, consumers’ demographic data was inaccessible due to privacy restrictions, which prevented insights into variables like age, gender, and socioeconomic background. Therefore, the study can only classify users based on self-reported symptoms.

Conclusion

The findings suggest that users perceive the app as a supportive and accessible tool for managing emotional challenges. User experiences highlight both the strengths of digital mental health applications and the limitations that influence trust, usability, and continued use. Though, digital platforms are revolutionizing mental health care but humanising of these apps may pose ethical concerns in form of emergency and crisis situation requiring immediate physical contact with the persons using these apps. Dependency on conversational chatbots like therapist has also emerged an interesting feature. Transference and countertransference during session through these apps could be an interesting future research area. In few instances, Digital mental health apps may be the first point of contact for those seeking support considering their round the clock, non-judgemental, affordable and no place constraint availability. Yet others, resort to these applications simultaneously along with other human based mental health support system. Technical glitches along with cost to use these apps are discouraging factors. In post-pandemic contexts, where students and young adults increasingly rely on digital ecosystems for emotional support and wellbeing management, digital mental health applications may serve as accessible supplementary support systems within educational environments.

Author contributions

M.A.V. and P.S. conceptualized the study. M.A.V. obtained the data and analyzed the data. P.S. reviewed the results analyzed. M.A.V. wrote the main manuscript. P.S. reviewed the manuscript and supervised the entire process.

Funding

Open access funding provided by Vellore Institute of Technology.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The present study involved the analysis of publicly available user reviews of the Amaha mental health application posted on the Google Play Store. The data analysed were limited to anonymised content voluntarily shared in the public domain and did not involve direct interaction with human participants, intervention, recruitment, or access to identifiable personal information. Consequently, formal ethical approval was not sought prior to conducting the study. The research was conducted in accordance with the Google Play platform’s terms of use and relevant ethical principles governing the use of publicly available data for research purposes. Consent to participate is not applicable for this study, as no direct recruitment or interaction with human participants was undertaken. The analysis was limited to anonymised user reviews that were publicly accessible on the Google Play Store. Permission to examine reviews pertaining to the Amaha application was obtained from the app provider.

Consent to publish

Consent to publish is not applicable for this study, as the data consisted of anonymised user reviews publicly available on the Google Play Store. Permission to analyse reviews pertaining to the Amaha application was obtained from the app provider. All findings are reported in aggregated thematic form without disclosure of personally identifying information.

Competing interests

The authors declare no competing interests.