Digital Mental Health Tool Development

By Vin Allen - Chapter board member

In the field of Contextual Behavioural Science, the notion that behaviour only makes sense "in its context" is central to how we think and work. It’s interesting, then, how easily this principle can be put aside when it comes to developing digital mental health tools. When building these tools, researchers often default to a top-down development methodology, presupposing how the tool should function, and ignoring the all-important context of the end user.

It's not surprising that this approach is so common. In many fields of healthcare research, the goal is to develop, define, and test a specific intervention, isolate its active component, and prove that it works consistently for as many people as possible. The trouble with applying this bio-medical approach to digital mental health research is that digital mental health tools aren’t a pill that someone passively takes or a generalisable mechanism of change within a therapy model. They are complex, context-specific tools, and their use and effectiveness are inextricably tied to the user's context. Getting somebody to take a pill, or even sit down for a 45-minute therapy session, is relatively simple. Ensuring ongoing engagement with an interactive digital intervention in a client’s busy everyday life can be considerably more difficult.

When we try to simply shoehorn an existing therapy model into a digital delivery system without considering these important contextual differences, we can end up with tools that, despite good intentions, are not very engaging and fail to meet the real-world needs of the target user.

So, what might a different approach to digital tool design look like? Incorporating the user's needs and experiences into the development lifecycle from the outset (not just via an after-the-fact feasibility trial!) is an effective way to ensure that the proposed digital intervention is genuinely useful. This suggests a mindset shift for the researcher: moving from the role of an expert with all the answers to that of a curious collaborator, working with target users to create something that fits their usage context.

This approach means starting not with a pre-defined digital "intervention" but with a broad goal, like making mental health support more accessible outside the therapy room. The first step then becomes talking with the people who will actually use the tool. What are their days like? What problems do they encounter that need solving? How might a digital tool solve those problems? By working together, the features and functions of the proposed digital tool can be shaped by the validated, real-world needs of the end-user. The researcher’s expertise and knowledge are still vital, but they are used to guide the process and ensure the final product is clinically sound, rather than to dictate the solution from the start.

Ultimately, it’s a small but powerful shift in thinking. Instead of seeing a user's context as a messy variable to control, we can see it as a key piece of the puzzle. It helps us ask not, 'Does this intervention I built work?' but rather, 'What would a helpful tool for this person, in their environment, actually look like?'

Any questions, comments, criticisms, or research collaboration requests, feel free to reach out. The more people doing effective user-centred digital mental health research, the better!

- Vin.

Connect with Vin on LinkedIn here, and check out his recent paper, published in JCBS.