title: Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.
abstract: BACKGROUND
  The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available.
  
  
  OBJECTIVE
  To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps.
  
  
  METHODS
  A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design.
  
  
  RESULTS
  Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp.
  
  
  CONCLUSIONS
  Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.
authors.affiliation: School of Psychology and Monash Institute of Cognitive and Clinical Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia. david.bakker@monash.edu.
authors.forename: David
authors.identifier: http://orcid.org/0000-0002-0343-1100
authors.initials: D
authors.lastname: Bakker
authors.forename: Nikolaos
authors.identifier: http://orcid.org/0000-0001-9559-4160
authors.initials: N
authors.lastname: Kazantzis
authors.forename: Debra
authors.identifier: http://orcid.org/0000-0002-4227-0231
authors.initials: D
authors.lastname: Rickwood
authors.forename: Nikki
authors.identifier: http://orcid.org/0000-0002-4236-8538
authors.initials: N
authors.lastname: Rickard
keywords: anxiety; apps; clinical psychology; cognitive behavior therapy; cognitive behavioral therapy; depression; mental health; mobile apps; mobile phones; smartphones