UC Santa Cruz

Rates of mental health conditions like depression and anxiety have been rising each year, especially during the COVID-19 pandemic. Despite the increasing prevalence of these conditions, barriers to accessing mental health care remain for many people in need of support. Digital mental health technology has proliferated in response to the increased rates of mental illness, as well as with the widespread adoption of smartphones. While prior work has rightly focused on the evaluation of the efficacy and evidential basis of these apps, there is a need for an examination of the subjective user experience of mental health apps. However, many apps are not supported by an evidential basis and, even highly valid apps struggle with low user engagement, as the adoption of technology is not necessarily driven by validity but rather user experience. The flexibility and constant availability of apps provide users with on-demand support not accessible through therapy or other traditional means of support. Conversational agents (chatbots), in particular, are increasingly better at simulating naturalistic interactions similar to those one would receive from a therapist or close friend. This paper describes two thematic analyses conducted on user reviews of 39 health and wellness apps, with a deep dive into six chatbot apps, as these are increasingly developed and downloaded. We discuss user-perceived benefits general to these types of apps – such as the 24/7 availability, social and motivational benefits – as well as benefits specific to apps implementing conversational agents, many pertaining to the development of some sort of advantageous relationship with a chatbot. We suggest implications for the future design and research of mental health apps.