Agarwal Smisha, Jalan Madhu, Hill Rachel, Pantalone Emily, Thrul Johannes, Sharma Ritu, Wilcox Holly C, Robinson Karen A
Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
BMC Health Serv Res. 2025 Apr 30;25(1):623. doi: 10.1186/s12913-025-12418-0.
Mental health mobile applications (apps) have the potential to expand the provision of mental health and wellness services to underserved populations. There is a lack of guidance on how to choose wisely from the thousands of mental health apps without clear evidence of safety, efficacy, and consumer protections. We propose the Framework to Assist Stakeholders in Technology Evaluation for Recovery (FASTER) to Mental Health and Wellness to support agencies and individuals working in mental health, as well as users of mental health apps, in making informed decisions recommending the use of, or using mental health and wellness apps. The framework was developed through a systematic process including a review of existing frameworks and the literature, interviews with key informants, public stakeholder feedback, and iterative application and refinement of the framework to 45 apps. It comprises three sections: Section 1. Risks and Mitigation Strategies, assesses the integrity and risk profile of the app; Section 2. Function, focuses on descriptive aspects related to accessibility, costs, developer credibility, evidence and clinical foundation, privacy/security, usability, functions for remote monitoring of the user, access to crisis services, and artificial intelligence (AI); and Section 3. Mental Health App Features focuses on specific mental health app features, such as journaling and mood tracking. The framework facilitates an assessment of the level of risk posed by the app against the evidence on the effectiveness of the app and its safety features, recognizing that given vast variations in health apps, a 'one size fits all' approach is likely to be insufficient. Future application, testing, and refinements may be required to determine the framework's suitability and reliability across multiple mental health conditions.
心理健康移动应用程序（应用）有潜力为服务不足的人群扩大心理健康和保健服务的提供。对于如何从成千上万款心理健康应用中明智选择，目前缺乏相关指导，这些应用在安全性、有效性和消费者保护方面并无明确证据。我们提出了心理健康与保健技术评估利益相关者辅助框架（FASTER），以支持从事心理健康工作的机构和个人以及心理健康应用的用户，在推荐使用或使用心理健康与保健应用时做出明智决策。该框架是通过一个系统的过程开发而成的，包括对现有框架和文献的审查、与关键信息提供者的访谈、公众利益相关者的反馈，以及对45款应用进行框架的迭代应用和完善。它包括三个部分：第1部分。风险与缓解策略，评估应用的完整性和风险状况；第2部分。功能，侧重于与可及性、成本、开发者信誉、证据和临床基础、隐私/安全、可用性、用户远程监测功能、危机服务获取以及人工智能（AI）相关的描述性方面；第3部分。心理健康应用功能，侧重于特定的心理健康应用功能，如日志记录和情绪跟踪。该框架有助于根据应用的有效性证据及其安全功能评估应用所带来的风险水平，认识到鉴于健康应用存在巨大差异，“一刀切”的方法可能并不充分。未来可能需要进行应用、测试和完善，以确定该框架在多种心理健康状况下的适用性和可靠性。
