TABLE 3.

Peer Support Specialists Representative.

Factor	Highlighted quotes
Technology ownership and use	“I use different apps or what not on my phone, but I think it would have to be put across in simpler terms for some–I think it’s different according to their age. You know older people would benefit from—They definitely would benefit from it, but it just would take a little practice.”
Knowledge of Privacy, Confidentiality and Ethics in mHealth tools	“Yeah, I have an app that’s called Calm but like for instance, here is an app called Sober Time, like track recovery, track sobriety, stay clean. Recovery. Time loss, twelfth, then there’s AA, there’s all sorts of AA apps. Recovery Box. Twelve steps in action, twelves steps in. . .oh that’s AA. You know, they go by different names. They target different subjects.”
	“with respect to the digital mental health interventions I am concerned with harming privacy from peer-to-peer and concerns confidentiality, especially with interventions that have multiple points of entry, which make them less secure.”
	“I assume that they [researchers] have to be HIPAA compliant. I have no concerns as long as the app requires some kind of a passcode.”
	“I have concerns about whether/how to intervene if someone posts suicide-related content on a message thread, as well as conflicts that might arise if such reporting breaches a user’s confidentiality rights.”
	“No concerns with digital health interventions because these are clients’ own phones; caveat of an intervention like this is that we have a paranoid population who might be hesitant to use anything that involves monitoring for supporting their recoveries. Other ethical concern is how reliance on smartphones and checking social media/communications can be damaging for some people and their recoveries.”
	“I think about people who have seeing- seeing visual things in their symptoms. Um, that aren’t really for the rest of us in the world. So, does that exacerbate a symptom or exacerbate a part of their reality that isn’t our reality and is that healthy or not? And I think about like the spectrum of conditions and so while we want to create an app that fits everyone’s needs, like there’s going to be conflicts of interest for like a person with depression versus a person who has a schizophrenia diagnosis because someone might have an altered reality and someone else might just have problems with motivation, and sadness, and isolation.”
Social media diagnostics, sensors, and passive monitoring of data	“It depends on how they’re monitoring technology use; if it’s monitoring being done by companies like Facebook or Amazon it’s not great, but if it’s being done by clinicians or peers for tracking clients in order to help people with recoveries then thinks it’s good. For instance, an app that ould allow a peer to have access to a homeless client’s location would be extremely helpful in helping to track down the person to meet with them.”