{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:33:46Z","timestamp":1790307226311,"version":"4.1.0"},"reference-count":64,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:p>Although efficacious psychotherapies exist, a limited number of mental health care providers and significant demand make their accessibility a fundamental problem. Clinical researchers, funders, and investors alike have converged on self-help digital mental health interventions (self-help DMHIs) as a low-cost, low-burden, and broadly scalable solution to the global mental health burden. Consequently, exorbitant financial and time-based resources have been invested in developing, testing, and disseminating these interventions. However, the public\u2019s assumed desirability for self-help DMHIs by experts has largely proceeded without question. This commentary critically evaluates whether self-help DMHIs can, and will, reach their purported potential as a solution to the public burden of mental illness, with an emphasis on evaluating their real-world desirability. Our review finds that self-help DMHIs are often perceived as less desirable and credible than in-person treatments, with lower usage rates and, perhaps accordingly, clinical trials testing self-help DMHIs suffering from widespread recruitment challenges. We highlight two fundamental challenges that may be interfering with the desirability of, and engagement in, self-help DMHIs: (1) difficulty competing with technology companies that have advantages in resources, marketing, and user experience design (but may not be delivering evidence-based interventions) and (2) difficulty retaining (vs initially attracting) users. We discuss a range of potential solutions, including highlighting self-help DMHIs in public mental health awareness campaigns; public education about evidence-based interventions that can guide consumers to appropriate self-help DMHI selection; increased financial and expert support to clinical researchers for marketing, design, and user experience in self-help DMHI development; increased involvement of stakeholders in the design of self-help DMHIs; and investing in more research on ways to improve retention (versus initial engagement). We suggest that, through these efforts, self-help DMHIs may fully realize their promise for reducing the global burden of mental illness.<\/jats:p>","DOI":"10.2196\/58198","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T15:01:12Z","timestamp":1726758072000},"page":"e58198","source":"Crossref","is-referenced-by-count":17,"title":["We Have Spent Time, Money, and Effort Making Self-Help Digital Mental Health Interventions: Is Anyone Going to Come to the Party?"],"prefix":"10.2196","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1347-1827","authenticated-orcid":false,"given":"Skye","family":"Fitzpatrick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7453-2398","authenticated-orcid":false,"given":"Alexander O","family":"Crenshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3587-1098","authenticated-orcid":false,"given":"Victoria","family":"Donkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6867-2173","authenticated-orcid":false,"given":"Alexis","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7116-5974","authenticated-orcid":false,"given":"Angela","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7163-1083","authenticated-orcid":false,"given":"Elizabeth A","family":"Earle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0479-7344","authenticated-orcid":false,"given":"Kamya","family":"Goenka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-8783","authenticated-orcid":false,"given":"Sonya","family":"Varma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2770-9648","authenticated-orcid":false,"given":"Julianne","family":"Bushe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3318-2610","authenticated-orcid":false,"given":"Tara","family":"McFadden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4952-4435","authenticated-orcid":false,"given":"Andrea","family":"Librado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-0788","authenticated-orcid":false,"given":"Candice","family":"Monson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2167-4086.2009.tb00426.x"},{"key":"ref2","unstructured":"World mental health report: transforming mental health for allWorld Health Organization20222022-06-16https:\/\/www.who.int\/publications\/i\/item\/9789240049338"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1177\/0840470418818583"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/cpsp.12235"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1177\/1745691610393527"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1080\/09638230410001669246"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-13-119"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.5172\/jamh.9.1.73"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27549"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2020.1836435"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113382"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2196\/21344"},{"key":"ref13","unstructured":"Unpublished raw data on the research portfolio of online reporting tools expenditures and results systemNational Institutes of Health2022-08-26https:\/\/reporter.nih.gov\/"},{"key":"ref14","unstructured":"ClayRAMental health apps are gaining tractionAmerican Psychological Association20212022-11-16https:\/\/www.apa.org\/monitor\/2021\/01\/trends-mental-health-apps"},{"key":"ref15","unstructured":"Grand View Research2022-11-16https:\/\/www.grandviewresearch.com\/industry-analysis\/mental-health-apps-market-report"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2196\/mental.7722"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-14-109"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1037\/cbs0000165"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2017.02.002"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1080\/15228835.2020.1833810"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2196\/mental.5324"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9109"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2017.12.002"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2196\/mental.6186"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1037\/cou0000108"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/790457"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000479"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000268"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000654"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1177\/0017896915581061"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22856"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2009.0296"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2008.01020.x"},{"key":"ref34","unstructured":"Kids can't wait: 2020 report on wait lists and wait times for child and youth mental health care in OntarioChildren's Mental Health Ontario20202022-12-01https:\/\/cmho.org\/wp-content\/uploads\/CMHO-Report-WaitTimes-2020.pdf"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2016.12.001"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1089\/cyber.2012.0515"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000635"},{"key":"ref38","unstructured":"Medicines and Healthcare Products Regulatory AgencyMental health funding of \u00a31.8m welcomed by MHRA and nice to explore regulation of digital mental health toolsGOV.UK20222024-07-22https:\/\/www.gov.uk\/government\/news\/mental-health-funding-of-18m-welcomed-by-mhra-and-nice-to-explore-regulation-of-digital-mental-health-tools"},{"key":"ref39","unstructured":"MiddletonJFirst smartphone app to gain FDA approval for depressionAmerican Academy of Family Physicians20242024-07-22https:\/\/tinyurl.com\/4a57hfxr"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.4108\/eai.13-7-2018.161419"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.09.018"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000686"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.2196\/25716"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.2196\/39204"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9275"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.2196\/14567"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31822363db"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2014.02.003"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2323"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.11.167"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0238-9"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.03.007"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22683"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1177\/1049731509347850"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00759"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2016.11.007"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1111\/camh.12659"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23920"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-021-01235-0"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1066"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1177\/2167702614548317"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24213"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2021.103983"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.2196\/33473"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2024\/1\/e58198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:49:50Z","timestamp":1782841790000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2024\/1\/e58198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,19]]},"references-count":64,"URL":"https:\/\/doi.org\/10.2196\/58198","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.58198","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,19]]}}}