Jin et al. (2025) conducted a systematic analysis of 111 articles to examine user engagement challenges in mobile mental health apps. Their review integrates findings across technological, psychological, motivational, and design perspectives to explain why sustained engagement remains difficult despite the growing availability and clinical promise of these interventions.
Mental health apps use smartphone data to offer personalized support based on what users share and how they behave, in combination with individuals' psychological traits, momentary mental states, and engagement patterns (Firth et al., 2017). Because these apps depend heavily on active user participation, maintaining engagement at levels necessary for clinical effectiveness has become a primary challenge.
Jin et al. (2025) describe engagement as a multidimensional and dynamic construct. It extends beyond simple usage frequency and includes behavioral engagement, as well as subjective experiences, including attention, interest, and emotional responses (Perski et al., 2017). Engagement is therefore fluid and varies across individuals and over time.
Importantly, the review highlights that individuals experiencing mental health problems frequently exhibit motivational deficits, impaired concentration, and difficulties establishing routines. These psychological characteristics are particularly relevant in the context of digital mental health support, where sustained engagement depends largely on self-initiated and consistent participation.
As a result, users may experience task fatigue, defined as a gradual decline in willingness or capacity to continue performing app-based therapeutic activities. In digital mental health interventions, task fatigue emerges when required actions are perceived as effortful, repetitive, or emotionally demanding.
Beyond individual-level psychological barriers, Jin et al. (2025) identify several structural and design-related factors that can further undermine engagement. Issues such as crashes, errors, data loss, high memory consumption, slow loading times, and poor synchronization reduce user satisfaction and disrupt continued use.
In response to these challenges, many mental health apps incorporate adaptive and personalized components to enhance engagement. Drawing on Self-Determination Theory (Ryan & Deci, 2000), the authors argue that intrinsic motivation is strengthened when autonomy, competence, and relatedness are supported.
Overall, Jin et al. (2025) demonstrate that sustainable engagement in mobile mental health interventions depends not only on personalization and technological sophistication, but on carefully balancing structure, flexibility, and users' psychological needs.