Recommendations of the ECNP Digital Network for the evaluation of mental health care apps: A Delphi consensus

The global rise in mental health problems has outpaced the availability of trained professionals, prompting interest in digital solutions such as mobile mental health applications (apps). These apps offer potential benefits including cost-effectiveness, accessibility, and personalized care. Here we provide expert consensus recommendations for evaluating mental health apps, developed by a taskforce of the European College of Neuropsychopharmacology (ECNP) Digital Network using a Delphi process. The consensus group agreed that minimum evaluation criteria should include measures of efficacy, usability, acceptability, user satisfaction, and monitoring of potential adverse effects. Dropout rates were identified as a critical indicator of real-world app use. Accordingly, the task force emphasized the importance of examining barriers to user engagement, as well as patterns of app usage and attrition, as essential components of evaluation. App assessments must also address data security and explicitly report any breaches or other iatrogenic effects. Where feasible, evaluations should track time spent on the app and frequency of use. In addition, app development should incorporate equity and psychosocial considerations that may restrict access to digital technologies, highlighting the importance of co-design with end users. By establishing minimum standards and promoting evidence-based evaluation, this consensus seeks to support the responsible integration of mental health apps into care systems, ensuring they are safe, effective, and equitable tools within the mental health landscape.