Background Digital health-tracking tools are changing mental health care by giving patients the ability to collect passively measured patient-generated health data (PGHD; ie, data collected from connected devices with little to no patient effort). Although there are existing clinical guidelines for how mental health clinicians should use more traditional, active forms of PGHD for clinical decision-making, there is less clarity on how passive PGHD can be used. Objective We conducted a qualitative study to understand mental health clinicians’ perceptions and concerns regarding the use of technology-enabled, passively collected PGHD for clinical decision-making. Our interviews sought to understand participants’ current experiences with and visions for using passive PGHD. Methods Mental health clinicians providing outpatient services were recruited to participate in semistructured interviews. Interview recordings were deidentified, transcribed, and qualitatively coded to identify overarching themes. Results Overall, 12 mental health clinicians (n=11, 92% psychiatrists and n=1, 8% clinical psychologist) were interviewed. We identified 4 overarching themes. First, passive PGHD are patient driven—we found that current passive PGHD use was patient driven, not clinician driven; participating clinicians only considered passive PGHD for clinical decision-making when patients brought passive data to clinical encounters. The second theme was active versus passive data as subjective versus objective data—participants viewed the contrast between active and passive PGHD as a contrast between interpretive data on patients’ mental health and objective information on behavior. Participants believed that prioritizing passive over self-reported, active PGHD would reduce opportunities for patients to reflect upon their mental health, reducing treatment engagement and raising questions about how passive data can best complement active data for clinical decision-making. Third, passive PGHD must be delivered at appropriate times for action—participants were concerned with the real-time nature of passive PGHD; they believed that it would be infeasible to use passive PGHD for real-time patient monitoring outside clinical encounters and more feasible to use passive PGHD during clinical encounters when clinicians can make treatment decisions. The fourth theme was protecting patient privacy—participating clinicians wanted to protect patient privacy within passive PGHD-sharing programs and discussed opportunities to refine data sharing consent to improve transparency surrounding passive PGHD collection and use. Conclusions Although passive PGHD has the potential to enable more contextualized measurement, this study highlights the need for building and disseminating an evidence base describing how and when passive measures should be used for clinical decision-making. This evidence base should clarify how to use passive data alongside more traditional forms of active PGHD, when clinicians should view passive PGHD to make treatment decisions, and how to protect patient privacy within passive data–sharing programs. Clear evidence would more effectively support the uptake and effective use of these novel tools for both patients and their clinicians.

BACKGROUND Digital health tracking tools intend to change mental healthcare by giving mental health clinicians passively measured patient-generated health data (PGHD) (e.g., data collected from connected devices, mobile applications, and wearables with little-to-no patient effort), providing contextual information on patient behavior and physiology from outside of the clinic with minimal data collection burden. While prior work has sought to understand how passive PGHD may be integrated within clinical workflows, researchers have not sufficiently explored how passive PGHD may reshape clinical decision making. OBJECTIVE We conducted a qualitative study to understand mental health clinicians’ perceptions and concerns regarding using technology-enabled, passively collected PGHD for clinical decision making. Our interviews sought to understand participants’ current experiences with and visions for using passive PGHD. METHODS Mental health clinicians (eg, psychiatrists, psychologists, clinical social workers) providing outpatient services were recruited to participate in semi-structured interviews. Interview recordings were de-identified, transcribed, and qualitatively coded to identify overarching themes. RESULTS 12 mental health clinicians (11 psychiatrists and 1 clinical psychologist) were interviewed. Our results showed that participating clinicians had varied experience with, and interest in, using passive PGHD, specifically highlighting the lack of evidence supporting passive PGHD use, as well as gaps in knowledge on how to best integrate passive PGHD alongside more-traditional forms of clinical mental health data. In addition, participating clinicians were only interested in viewing passive PGHD at moments when they could reflect and act on passive data; drawing an analogy to a prescription or lab test, PGHD could be prescribed or ordered at opportune moments to hyperfocus on the relationships between behavior, physiology, and disease for a discrete period of time. Finally, participants called for safeguards to protect patient privacy within passive PGHD data sharing programs, ensuring passive PGHD is only collected and used to support patients’ treatment goals. CONCLUSIONS While passive PGHD has the potential to enable more contextualized measurement, this study highlights the need for building and disseminating an evidence base describing how and when passive measures should be used for clinical decision making. Clear evidence would more effectively support the uptake and effective usage of these novel tools for both patients and their clinicians.