Creative Design Approaches in Digital Mental Health Interventions: Exploratory Mapping Review (Preprint)

BACKGROUND Digital mental health interventions show great potential to alleviate mental illness and increase access to care. However, these technologies face significant problems in terms of adoption. While it is suggested that this issue stems from a lack of user perspective in the development process, several creative design approaches have been developed over the years to consider this important aspect. Still, there have been few examples of creative design approaches and end users' involvement in the development of digital solutions in the field of mental health. OBJECTIVE The main objective of this literature review was to understand how design is considered in e-mental health intervention research. METHODS An exploratory mapping review was conducted among journals with an explicit scope covering mental health and technology. The creative design approaches reported and the core elements of a design activity (i.e., the object, the context, the design process and the actors involved) were examined among the eligible studies. RESULTS 30 studies met the inclusion criteria. 22 studies mentioned using creative design approaches or specific design methods in the development of an e-mental health solution. Approaches reported could be classified as participatory design (n=11), codesign (n=6), user-centered-design (n=5) or specific design methods (n=5). Just about half of the approaches mentioned (n=15/27) were supported by references. It was not possible to associate any creative design approaches with the description made of the main core elements (i.e., process, actors). End users were involved to some extent in all studies. For their part, designers were only involved in 8 studies, which was less than software development teams (n=14). That said, unlike the latter, their presence was noticed throughout the design process. CONCLUSIONS Results show that there are attempts to integrate creative design approaches into the development of e-mental health solutions. However, they rely very little on designers nor design research. Researchers and technology developers should know the underpinnings of creative design methods when choosing an approach over another. They should also consider involving designers to fully implement those methods and approaches.