Determination of Markers of Successful Implementation of Mental Health Apps for Young People: Systematic Review

Background: Smartphone applications (‘apps’) have the potential to address some of the current issues facing service provision in young people’s mental health by improving the scalability of evidence-based mental health interventions. However, very few apps have been successfully implemented and consensus on implementation measurement is lacking.
Aim: To determine the proportion of evidence-based mental health and wellbeing apps that have been successfully adopted and sustained in ‘real-world’ settings. A secondary aim was to establish if key implementation determinants such as co-production, acceptability, feasibility, appropriateness, and engagement contribute towards successful implementation and longevity.
Methods: Following the PRISMA guidelines, an electronic search of five databases in 2021 yielded 18,660 results. After full-text screening, 34 articles met full eligibility criteria, providing data on 29 smartphone apps studied with individuals aged 15–25.
Results: In total, 10 papers evaluated the effectiveness of an existing, commercially available app. Of the studies reporting the development and evaluation of a newly developed app (n = 24), 12 (50%) are currently available commercially, or otherwise (e.g., in mental health services, universities), and 12 (50%) are no longer available. Most implemented apps confirmed addressing some components needed to ensure successful adoption, acceptability, appropriateness, feasibility, and engagement. Factors including high cost, funding constraints and lengthy research processes were identified as impeding implementation. Conclusions: Without addressing common implementation drivers there is considerable redundancy in the translation of research findings into practice. To address common implementation barriers of digital apps, including time, and financial constraints, studies could embed implementation strategies from the outset of the planned research, building collaborations with partners already working in the field (academic, commercial) to capitalise on existing interventions and platforms, modifying and evaluating them for local contexts or target problems/populations. Innovative funding mechanisms that are quick and encourage stakeholder and industry partnerships might better ensure that mental health and wellbeing app development, evaluation, implementation, and sustainability promotes scalable evidence-based interventions for young people.