A Social Support-Enabled Mobile Health (mHealth) Application for Adolescent Depressive Symptomatology: Is it Usable and Feasible?
Authors: Masoom Gilani Sayyida , Fermi Pasha Muhammad , Thanzami Vanlal , Delir Haghighi Pari 
Published: November 2024

Over the last decade, there has been a remarkable expansion in designing and developing mobile health (mHealth) applications for prevention and/or intervention of a wide range of mental health problems, which have negative consequences on the physical health and everyday routine of individuals. With the onset of these mental illnesses during adolescence, mental health apps (MHapps) are especially a promising approach for depression, which is one of the most common and leading causes of mortality and morbidity in this vulnerable age, and is yet underrecognised, underdiagnosed and undertreated. However, the majority of MHapps available for download in commercial marketplaces do not adhere to evidence-based treatment guidelines, nor are supported by evidence-based research. Despite the potential advantages of mHealth apps in promoting mental health and well-being, particularly in adolescents with depression, extensive multidisciplinary systematic literature searches across various databases reveal a scarcity of research-based MHapps focusing on this population. Furthermore, most existing mHealth apps rely on self-reported symptom-based screening of depressive symptoms and provide low-intensity psychological interventions with minimal or no therapist involvement. Although numerous studies validate these approaches, researchers note insignificant or very small effect sizes for self-management-oriented mHealth interventions due to the persistent presence of loneliness, a core symptom of depression, resulting from limited human interaction. To alleviate depressive symptomatology and elevate psychological well-being in adolescents, a rule-based and evidence-based professional and peer social support framework to be integrated and incorporated in MHapps was investigated, proposed, implemented, refined, and tested based on comprehensive multidisciplinary literature reviews in mHealth and mental health domains, and usability testing with technical experts. This paper presents a step-by-step usability and feasibility assessment of the iteratively and incrementally refined theory-driven social support-enabled mHealth application in the real-world with school-going adolescents, licensed mental health counsellors and a moderator over a 4-week period. The critical analysis of both quantitative and qualitative results indicated a positive reception with participants expressing appreciation for the app's usability and potential impact on their well-being. The average SUS scores of 70.8 and 93.8 from adolescents and counsellors, respectively, underscored the acceptability of the social support-enabled mHealth app with 13 themes emerging from analyses of both participants’ responses to the five open-ended questions. These contributions serve to highlight the significance of integrating social support into mHealth interventions for adolescent depressive symptomatology, thereby expanding access to mental healthcare as well as saving time and resources. Fundamentally, these user-centric findings and their implications can be vital for mobile mental health research and community in making targeted improvements and facilitating optimal mental health and well-being in adolescents.