Public availability of evidence-based mental health apps: a systematic review and meta-analysis of self-guided apps

Despite mental health apps having a rigorous evidence base, little is known about the proportion of efficacious apps that are publicly available. Our systematic review and meta-analysis identified self-guided mental health apps evaluated in controlled trials, determined their public availability, and examined how evidence quality and strength influence availability. A literature search identified 16,971 records, of which 110 studies, investigating 112 apps, met inclusion criteria. Of the 81 unique self-guided apps, 42 (52%) were publicly available. Apps were most commonly available through both Apple App and Google Play Stores (79%) at no cost (40%). Study quality assessed using Cochrane Risk of Bias 2 tool had no significant association with app availability (p = 0.851). Meta-analysis found no significant difference (p = 0.228) in effect size compared to control between available apps (g = 0.33) and unavailable apps (g = 0.45). Considerations apart from evidence quality or strength determine app translation highlighting a gap between evidence and availability.