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IntroductionPersonal technology (e.g., smartphones, wearable health devices) has been leveraged extensively for mental health purposes, with upwards of 20,000 mobile applications on the market today and has been considered an important implementation strategy to overcome barriers many people face in accessing mental health care. The main question yet to be addressed is the role consumers feel technology should play in their care. One underserved demographic often ignored in this discussion are people over the age of 60. The population of adults 60 and older is predicted to double by 2,050 signaling a need to address how older adults view technology for their mental health care.ObjectiveThe objective of this study is to better understand why digital mental health tools are not as broadly adopted as predicted, what role people with lived mental health experience feel technology should play in their care and how those results compare across age groups.MethodIn a mixed-methods approach, we analyzed results from a one-time cross-sectional survey that included 998 adults aged 18–83 with lived experience of mental health concerns recruited from Prolific, an online research platform. We surveyed participant's use of technology including their perspectives on using technology in conjunction with their mental health care. We asked participants about their previous use of digital mental health tools, their treatment preferences for mental health care, and the role technology should play in their mental health care.ResultsAcross all age groups, respondents had favorable views of using digital mental health for managing mental health care. However, older adults rated their acceptability of digital mental health tools lower than middle-aged and younger adults. When asked what role technology should play in mental health care in an open-ended response, most participants responded that technology should play a complementary role in mental health care (723/954, 75.8%).ConclusionDigital mental health is seen as a valuable care management tool across all age groups, but preferences for its role in care remain largely administrative and supportive. Future development of digital mental health should reflect these preferences.

Background: The global ubiquity of smartphone use among young people makes them excellent candidates for collecting data about individuals’ lived experiences and their relationships to mental health. However, to-date most app-based studies have been conducted in North America and Europe. Understanding young people’s willingness to participate in app-based research and share information about their mental health is key to understanding the feasibility of broad-scale research using these approaches. We aimed to understand the recruitment and engagement approaches influencing young peoples’ (aged 16-24) participation in app-based studies of mental health. We hypothesised that providing a choice of study topics will improve engagement. Methods: We developed a 12-week pilot study of mental health implemented in the MindKind app, designed to assess participants’ willingness to engage in remote mental health research, both actively and passively. Enrollees were randomised to one of two different engagement arms, either selecting their study topics of interest or receiving a fixed assignment of study topics, in order to understand the role of choice in study engagement. This pilot study was conducted in India, South Africa, and the United Kingdom. Different recruitment strategies were employed in each location. Results: The MindKind Study recruited 1,034 (India), 932 (South Africa) and 1,609 (UK) participants. Engagement differed by country with median days of activity = 2, 6, and 11 for India, South Africa, and UK, respectively. Most surprisingly, participants given a choice of study topics showed lower engagement relative to participants assigned to fixed topics (Hazard Ratio = 0.82). Conclusions: We observe equal or better engagement compared to previous comparable app-based studies of mental health. While providing participants a choice of study topics showed no advantage in our study, our qualitative analysis of participant feedback provides additional suggestions for improving engagement in future studies.

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