Table 2.
Characteristics of included reviews.
| Authors, Year of Publication | Review Type | Review Objective | Total Sample Size | Participant Demographics (Age) | Country | Number of Sources Searched | Date (Year) Range of Included Studies | Number of Studies Included | Method of Analysis | Key Findings |
|---|---|---|---|---|---|---|---|---|---|---|
| Alqahtani and Orji [32] | User review analysis | Examine strengths and weaknesses of apps | 13,549 user reviews | NA | NA | 2 (Apple’s app store, Google Play) | NA | 106 mental health apps | Thematic analysis | Apps interface and user-friendliness are strengths. Apps lack content, personalization, security, and privacy. |
| Bakker et al. [33] | Lit. review | Provide recommendations for future apps development | 27 mental health apps | NA | NA | 3 (PsycInfo, Scopus, ProQuest) | Mar 1975–Mar 2015 | 27 mental health apps | NA | Current lack of trial-based evidence for apps, need more RCTs. |
| Balcombe et al. [34] | Lit. review | Summarize and evaluate digital mental health for athletes | NA | NA | NA | 2 (PubMed Central, Directory of Open Access Journals) | 2016–2020 | NA | Systematic review | Apps’ real-time function helpful for symptom tracking and mental health screening. Apps face engagement issues. |
| Binhadyan et al. [35] | Lit. review | Examine current trend of e-mental health and issues related with ADHD | NA | 16 and above | NA | 7 (ACM Digital Library, ScienceDirect, IEEE Eplore, SpringerLink, ProQuest, Australian Standards, Google Scholar) | After 2004 | 74 | Systematic review | E-mental health improves treatment accessibility, reduces cost, and enhances quality. |
| Borghouts et al. [18] | Systematic review | Identify barriers and facilitators affecting e-mental health user engagement | NA | 16 and above | NA | 5 (SCOPUS, PubMed, PsycINFO, Web of Science, Cochrane Library) | After 2010 | 208 articles | Systematic review | Barriers: severe mental health, apps have technical and lack of personalization issues. Facilitators: social connections and mental health awareness. |
| Carter et al. [36] | Lit. review | Provide benefits of digital mental health interventions in low-middle and middle income countries | NA | NA | East, Central, South Asia, Central Latin America, Middle East, Eastern Europe, Southeast Asia, Africa | 1 (Medline) | 2016–2020 | 37 articles | Systematic review | Digital mental health can help to detect, diagnose, prevent, and treat mental health disorders in these countries. |
| Chan and Honey [9] | Lit. review | Identify users perception of mental health apps | NA | 18 and above with mental health condition | USA, Spain, Sweden, UK, Europe, Asia, Dominican Republic, Canada, Germany, Australia | 4 (CINAHL, Embase, Medline, PsycInfo) | After 2000 | 17 articles | Integrative review | Apps are useful supplement to treatment. Ease of use, content, and privacy are concerns of apps usage. |
| Denecke et al. [37] | Lit. review | Identify aspects of CBT in mental health apps | NA | 18 and above | NA | 3 (PubMed, IEEE Xplore, ACM digital library) | 2007–2020 | 34 articles | Narrative synthesis | Promote self-monitoring and self-management strategies. |
| Drissi et al. [38] | Lit. review | Identify e-mental health for healthcare staff | NA | NA | China, UK, Iran, Canada, USA, Malaysia | 5 (IEEE, ACM, ScienceDirect, Scopus, PubMed) | 2020 onwards | 11 articles | Systematic review | E-mental health helpful but lacks empirical evidence. |
| Eisenstadt et al. [15] | Systematic review and meta-analysis | Identify features of mental health apps and evaluate potential | 48 mental health apps | 18–45 | 15 countries | 5 (Medline, Embase, PsycInfo, Web of Science, Cochrane Central) | Up to 2021 | 52 articles | Narrative synthesis and meta-analysis | Apps promote emotion regulation, mental health, and well-being. |
| Ellis et al. [39] | Scoping review | Assess e-mental health gaps in relation to COVID-19. | NA | NA | USA, Australia, Canada, UK, India | 4 (Medline, Embase, PsycInfo, CINAHL) | 2019–2021 | 356 articles | Narrative techniques | Privacy and safety regulations, lack integration into healthcare models and accountability framework. |
| Firth et al. [19] | Meta-analysis | Examine efficacy of using smartphones for treatment of depression | 3414 | 18–59.3 | NA | 7 (Cochrane Central, Health Technology Assessment Database, AMED, HMIC, Ovid Medline, Embase, PsycInfo) | Until 2017 | 18 RCTs | Comprehensive Meta-analysis 2.0 | Smartphones are a promising self-management tool for depression. |
| Garrido et al. [20] | Systematic review and meta-analysis | Examine effectiveness of digital mental health for anxiety and depression in young people | NA | 12–25 | Australia, USA, Asia, North Europe, South America | 4 (PsycInfo, PubMed, ProQuest, Web of Science) | 2007–2017 | 41 articles | Thematic analysis and narrative analysis | Treatment effect high when supervision was present, content and interface important to users. |
| Gould et al. [40] | Lit. review | Summarize feasibility, usability, efficacy, effectiveness of mental health apps | NA | NA | NA | 1 (EBSCOhost) | Until 2018 | 22 articles | Systematic review | There is evidence for feasibility and acceptability, research for efficacy and effectiveness is scarce. |
| Harith et al. [41] | Umbrella review | Synthesize and evaluate digital interventions targeting university students | NA | University students | Australia, UK, USA, Canada, Norway, Spain, China, Europe | 5 (PubMed, Psychology and Behavioral Science Collection, Web of Science, ERIC, Scopus) | 2000–2021 | 7 articles | Narrative synthesis | Digital interventions were effective; effectiveness depended on delivery format, mental health condition, and population. |
| Henson et al. [12] | Lit. review | Determine digital therapeutic alliance in smartphone interventions for mental illnesses | NA | 17–65 | NA | 4 (PubMed, PsycInfo, Embase, Web of Science) | 2018 onwards | 5 articles | Systematic review | Smartphones enhance therapy engagement and adherence, therapeutic alliance in allowing communication outside therapy hours was key. |
| Hwang et al. [42] | Scoping review | Examine effects of mobile mental health apps for adults | NA | 18 and above | NA | 8 (RISS, DBpia, Medline, CINAHL, Embase, PsycInfo, Cochrane Library, Google Scholar) | 2010–2019 | 14 articles | Systematic review | Apps based on theoretical knowledge and empirical evidence were lacking. |
| Kaveladze et al. [43] | Secondary data analysis | Examine relationship among subjective user experience and objective measures of apps popularity and engagement | NA | NA | NA | 4 (MARS, Apple App Store, Google Play, MAU) | 2020–2021 | 56 apps | Statistical analyses using R | User experience does not predict sustained engagement with apps. Need to understand the link between user experience and engagement. |
| Lal and Adair [44] | Rapid literature review | Review the literature on e-mental health, including its applications, strengths, limitations, and evidence base | NA | NA | USA, Australia, the Netherlands | 1 (MEDLINE) | 2000–2010 | 115 | Descriptive review | E-mental health applications address information provision; screening, assessment, and monitoring; intervention; and social support. |
| Larsen et al. [21] | Systematic overview | Compare evidence-based strategies undertaken for suicide prevention with the content of publicly available apps providing tools for suicide prevention | NA | NA | NA | 2 (Australian Google Play store, Australian iTunes store) | NA | 123 apps | Systematic review | Strongest evidence of suicide prevention strategies found for facilitating access to crisis support. All reviewed apps employed at least one strategy that aligned with best-practice or evidence-based guidelines. |
| Lattie et al. [22] | Systematic review | Identify the effectiveness, usability, acceptability, uptake, and adoption of digital mental health interventions focused on depression, anxiety, and enhancement of psychological well-being among college students | NA | NA | Mexico, Canada, USA | 5 (MEDLINE, EMBASE, PsycINFO, Web of Science, and the Cochrane Library) | Up to 2019 | 89 | Systematic review | The majority of programs were effective or partially effective in producing beneficial changes in the main psychological outcome variables. |
| Leech et al. [23] | Systematic review | Provide a systematic, quantitative review of current research to address whether app-based interventions are effective in managing adolescents and young adults’ mental health symptoms compared to wait-list controls or another comparison condition. | 1706 | Mostly adolescent females (65% female; Mean age = 18.9 years, SD = 3.5) | Australia, UK, USA | 4 (Embase, Cochrane Library, PsycINFO, PubMed) | 2011–2020 | 11 RCTs | Meta-analysis | App interventions produced significant symptom (depression, stress) improvement across multiple outcomes, compared to wait-list or attention control conditions. |
| Lehtimaki et al. [24] | Systematic overview | Synthesize the current evidence on digital health interventions targeting adolescents and young people (aged 10–24 years) with mental health conditions, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings | Not reported | Not reported | China, HK, the Netherlands | 4 (MEDLINE, PubMed, PsycINFO, Cochrane) | 2013–2019 | 18 | Systematic review | Evidence of effectiveness of computerized CBT on anxiety and depression; interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. |
| Liverpool et al. [25] | Systematic review | (1) Identify modes of delivery used in children and young people’s digital mental health interventions (DHI), (2) explore influencing factors on usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether children and young people engage in DHIs | Not reported | Not reported | USA, Canada, Australia | 4 (Cochrane Library, EMBASE, MEDLINE, PsycINFO) | 2001–2018 | 83 | Narrative synthesis | Six modes of delivery were identified: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Two themes of intervention-specific (suitability, usability, and acceptability of the DHI) and person-specific (motivation, capability, opportunity) barriers and facilitators to CYP’s engagement emerged. |
| Murphy et al. [45] | Rapid scoping review | (1) Identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, (2) identifies needs and gaps in access to standard and e-mental health care among these populations, and (3) explores the potential of e-mental health to address these needs | Not reported | Not reported | USA, China, Philippines | 3 (Medline, Embase, PsycINFO) | 2019–2020 | 132 | Narrative review | Evidence that e-mental healthcare can be a viable option for care delivery but that specific accessibility and acceptability factors must be considered. |
| Nicholas et al. [26] | Systematic review | Identify the types of self-management apps available for bipolar disorder and to assess their features and the quality of their content | NA | NA | NA | 2 (Australian Google Play and iOs stores) | NA | 82 apps | Systematic review | 22% of apps addressed privacy and security by providing a privacy policy; 36% and 15% applied core psychoeducation principles and best-practice guidelines, respectively. |
| Oyebode et al. [46] | Thematic analysis | Evaluate mental health apps by identifying positive and negative factors affecting the effective delivery of mental health apps | 88, 125 reviews | NA | NA | 2 (Google Play, App Store) | NA | 104 apps | Thematic analysis | Identified 21 negative themes (usability issues, content issues, ethical issues, customer support issues, billing issues) and 29 positive themes (aesthetically pleasing interface, app stability, customizability, high-quality content, content variation/diversity, personalized content, privacy and security, low-subscription cost). |
| Petrovic and Gaggioli [47] | Scoping review | Investigate and thematically synthesize the existing literature to understand the state of the art digital mental health tools for managing burden, stress, and overall adverse mental health outcomes for the informal caregivers of older adults | Not reported | Not reported | Not reported | 3 (Summon search box, Cochrane Library, PubMed) | 2016–2019 | 16 | Thematic synthesis | Overall, digital mental health interventions contribute to reducing the caregiver burden, with a limitation in addressing specific coping skills or education regarding illnesses such as Alzheimer’s disease and dementia. |
| Simblett et al. [27] | Systematic review and meta-analysis | Examine the scope and efficacy of e-mental health interventions to treat symptoms of PTSD | 3832 (eligible for meta-analysis) | Not reported | USA, The Netherlands, Australia | 4 (Cochrane Library, MEDLINE, EMBASE, PsycINFO) | 2001–2016 | 39 | Meta-analysis | The results of the primary meta-analysis revealed a significant improvement in PTSD symptoms, in favor of the active intervention group, independent of the comparison condition, type of CBT-based intervention, and level of guidance provided. |
| Six et al. [28] | Systematic review and meta-analysis | Examine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms compared to apps that lack these elements | 8110 | 58.3% female, mean age = 35.6, SD = 7.9 years | Not reported | 5 (PubMed, PsycINFO, Cochrane Clinical Trials Registry, Web of Science, PsyArXiv) | 2011–2020 | 38 | Meta-analysis | Results indicated a small to moderate effect size across all mental health apps in reducing depressive symptoms compared to controls; no difference in effectiveness between mental health apps with and without gamification elements. |
| Struthers et al. [29] | Systematic review | Examine the acceptability of e-mental health services for children, adolescents, and young adults and their parents and healthcare providers | Not reported | Mean age for all studies was <25 years | Australia, USA, UK | 11 (PubMed/Medline, EMBASE, CINAHL, PsycINFO, Google Scholar, Science Citation Index/Science Citation Index Expanded, Web of Science, Prouest, www.clinicaltrials.gov, Cochrane Central Register of Controlled Trials, and Google) | 1990–2012 | 24 | Systematic review | Clients are generally satisfied with e-mental health and report positive experiences, although adherence and uptake can be challenges |
| Thach [48] | Qualitative analysis of user reviews | Examine which design factors of mental health apps are significant/essential/unnecessary to consumers, and which factors affect user adherence | 1116 reviews | NA | NA | MHapps within the list reviewed by MH professionals published on website for Anxiety and Depression Association of America (ADAA) | User reviews posted from 2016 to 2017 | Five CBT-based apps: Pacifica, Happify, MindShift, MoodToosl, Moodkit | Qualitative analysis | Users highly appreciate the ability to monitor and reflect on themselves, and to figure out what is going on in their mood. By contrast, key aspects of dissatisfaction include technical issues, lack of customer service, clear security measures, and privacy policy. |
| Thach [49] | Qualitative analysis of user reviews | In the context of cognitive behavioral therapy (CBT)-based mental health applications examine (1) who are intended users, (2) what they use these apps for, and (3) why they use it | 1116 reviews | NA | NA | MHapps within the list reviewed by MH professionals published on website for Anxiety and Depression Association of America (ADAA) | User reviews posted from 2016 to 2017 | Five CBT-based apps: Pacifica, Happify, MindShift, MoodToosl, Moodkit | Qualitative analysis | CBT-based apps are used to relax, track mood, practice mindfulness, self-care, or build healthy habits. Apps are used to understand one’s health, help to keep on progressing with health, to see correlation between causes and effects of one’s health problems, to conduct self-evaluation and self-reflection, to build good habits, and to provoke, reframe, and organize their thoughts. |
| Torous et al. [14] | Clinical review | Review current challenges surrounding user engagement with mental health smartphone apps | NA | NA | NA | NA | NA | NA | Narrative review | Identified that mental health smartphone apps are (1) not user-friendly, (2) are not designed in a user-centric manner, (3) do not respect privacy, (4) are seen as an untrustworthy source of mental health information, and (5) are unhelpful in emergency situations |
| Wies et al. [50] | Scoping review | Synthesize the growing literature on the benefits and ethical challenges of digital mental health for young people (children or adolescents) aged 0 to 25 | Not reported | Not reported | Not reported | 6 (PubMed, Scopus, World of Science, PsycINFO, IEEE Xplore, ACM Digital Library) | Up to 2020 | 26 | Qualitative thematic synthesis | Identified diverse themes related to the opportunities (better understanding of mental health, patient empowerment and respect for autonomy, equality, increased accessibility, affordability, and availability of care) and ethical challenges (impact on patient-doctor relationship, insufficient validation of technological tools, risk of stigma, data security and privacy risks) of digital mental health technologies |
| Zhang et al. [30] | Systematic review | Examine the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China | 3112 | Mean age ranged from 4.7 to 47.4 years | Mainland China | 7 (Medline, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, VIP) | 2013–2021 | 39 | Narrative synthesis | DHTs were acceptable and usable among Chinese people with mental health problems in general |