Helping Older Veterans Use Mental Health Apps: Qualitative Interviews and Development of a New Program

Mobile mental health apps may provide an accessible, scalable, and private avenue for older veterans who may not otherwise seek or receive care to address their mental health concerns. However, older veterans may experience barriers to using these apps that need to be addressed to facilitate effective use. Such support could be effectively implemented within the US Veterans Health Administration to facilitate the use of the United States Department of Veterans Affairs' established mental health apps and to benefit older veterans with mental health concerns.

This study aimed to (1) assess older veterans' interest in and barriers to using mental health apps to address problems such as difficulties with social connection, and (2) develop and pilot a coaching program to address barriers that older veterans experience in using mobile devices and apps.

Rapid qualitative analysis of semistructured qualitative interviews with 12 older veterans identified themes regarding interest, barriers, and preferences for support for using mobile apps. These themes informed the development of a coaching program, which was piloted with 13 older veterans to assess acceptability, feasibility, and resultant signals of changes in mobile device proficiency.

Most veterans expressed interest in using mental health apps. One of the most common barriers was familiarity and proficiency with mobile devices and app technology. Other common barriers included usability or accessibility of the technology or app, motivation, and memory. Veterans reported interest in receiving coaching support. Though the majority of veterans expressed some preference for more individualized and in-person support, they identified both benefits and drawbacks to all potential coaching modalities (group vs one-on-one, in-person vs remote)-including issues of individualizable and guided assistance, feasibility and accessibility of the support, and group settings as potential avenues for social connection as well as potential susceptibility to challenging social dynamics and interactions. Mobile Device and App Learning (MoDAL)-a 2-session, interactive, remote educational group-was developed and piloted. Most veterans who participated found MoDAL helpful. Participants' mobile device proficiency showed a statistically significant improvement on average pre- to post-MoDAL, although this effect was small, and the small sample size limits the strength of the conclusions.

Older veterans do have some interest in using mobile mental health apps to address mental health-related issues. However, they experience critical barriers, including a lack of familiarity and proficiency with the technology. MoDAL may improve older veterans' comfort and proficiency with mobile devices and apps, which could address one of the barriers that impacts downstream engagement in mental health apps and other virtual care modalities.