Environmental Scan of Mental Health App Libraries

Key Messages

The Challenge

• Mental health apps offer new ways to access mental health information, self-management tools, and services. However, the number of available apps and differences in quality, privacy, security, evidence, and usability can make it difficult for end users and health care professionals to identify appropriate digital mental health resources.
• Mental health app libraries and gateway models have emerged as approaches to help end users, clinicians and other mental health care providers identify, assess, and navigate digital mental health resources. However, these models vary in their purpose, functions, governance, and operating approaches, raising questions about which approaches may be appropriate in the Canadian context.

The Evidence

• Canada’s Drug Agency conducted this Environmental Scan in response to an external request by the Mental Health Commission of Canada (the Commission) to understand the opportunities and challenges of mental health app libraries and gateway models that exist in Canada and internationally. The scan examined published and grey literature on mental health app libraries and gateway models in Canada and internationally. It considered model design, governance structure, implementation, use, funding, maintenance, sustainability, and emerging trends.
• CDA-AMC also surveyed health organizations, clinicians and other mental health professionals, and people with lived experience to provide additional context on the implementation, use, and considerations relevant to these models. The Commission supported survey engagement through their existing networks.

What CDA-AMC Found

• Mental health app libraries and gateway models differ in their scope, governance structure, assessment approaches, and integration with health systems.
• App libraries primarily assess, curate, and present information about digital mental health apps. Gateway models have a broader function and may combine app discovery with features such as self-assessment, guided navigation, referral pathways, service directories, crisis resources, and links to health and community services. A gateway may or may not also include an app library component.
• Common considerations for the design, implementation, and ongoing operation of mental health app libraries and gateway models include governance, transparent app assessment, privacy, accessibility, provider engagement, integration with care, maintenance, and sustainable operational capacity.
• Survey respondents reinforced the importance of privacy and data protection, usability and accessibility, trust and organizational credibility, and evidence of effectiveness when considering the use and uptake, adoption, recommendation, and implementation of these models. They also highlighted implementation considerations, including cost, funding, infrastructure, and service integration.

Why It Matters

• Implementing a mental health app library or gateway model involves more than developing a digital platform. The evidence identified in this scan indicates that implementation involves clear governance, sustained operational support, integration with existing services, and ongoing evaluation.
• The literature identified in this Environmental Scan provided limited comparative or long-term information on effectiveness, costs, workforce requirements, sustainability, and health system impacts. Further evaluation could examine these areas.
• These findings provide important considerations to inform evidence-based planning and policy considerations related to mental health app library and gateway models in Canada.