Using App Store Reviews to Explore User Experiences and Perceptions of Mental Health Mobile Apps: Qualitative Study

With the rise of digital health, mental health apps (MHapps) have become an increasingly popular tool in the self-management of depression, anxiety, and stress. Star ratings are often used as indicators of app quality to guide selection. However, ratings do not fully capture if the MHapp's features, usability, or design elements exhibit the heterogeneous real-life user experiences. Instead, examining the patterns of engagement and app usage can highlight whether high ratings reflect diverse user needs.

This study aimed to examine user experience of top-rated depression and anxiety apps to assess if user perceptions, as reported in app reviews, align with star ratings.

To identify relevant mobile apps, we used a systematic search strategy that mimicked a typical user's journey and applied search terms related to depression, anxiety, and stress management. Apps were screened using a predefined inclusion criteria that guided the identification of the 5 most highly rated MHapps, yielding approximately 750 user reviews across all apps. Reviews were analyzed using hybrid inductive and deductive coding techniques, with codes generated iteratively to capture the spectrum of user perceptions and experiences. Codes were then clustered, leading to theme generation that provided a deeper understanding of user experiences.

User experiences demonstrated a complex interplay between perceived benefits and frustration. Users valued ease of navigation, convenience, accessibility, and low-effort features that allowed easier entry to self-management of mental health. Users expressed their affinity toward specific app features and desire for the addition of new features that could further support their mental wellness. However, limited or restrictive features due to paywall, in-app advertisement placement, and functionality issues resulting from technical issues or bugs garnered substantial criticism.

This study highlights the complexity of user perceptions influencing experience with self-management MHapps. Despite high star ratings, app usability elicited paradoxical responses and showed multiple overlapping themes, showcasing features that may support some users but hinder others. The results emphasize that star ratings alone are insufficient to showcase if a MHapp meets user needs. Continued improvement in app design such as interface usability, feature development, and pricing transparency is needed to meet the diverse needs of users for better engagement and satisfaction.