OBJECTIVES: Digital mental health therapeutics (DMHT) have the potential to enhance the delivery of mental healthcare. However, there is little information on how DMHT are evaluated and what factors influence their use. This study aimed to understand how DMHT are valued in the United States (US) from consumer, payer, and employer perspectives.

METHODS: A systematic literature review was conducted searching MEDLINE, Embase, PsycInfo, Cochrane Library, Health Technology Assessment Database, and digital and mental health congresses. Articles were reviewed by two independent reviewers for eligibility. Studies of interest were those that reported data (quantitative or qualitative) on factors considered in the evaluation of DMHT targeting mental health or central nervous system indications in the US, published from 2017 onwards. The American Psychiatric Association’s (APA) Mental Health App Evaluation Framework was used to evaluate studies. Studies were coded and indexed using the APA framework to explore themes on the value of DMHT. Novel themes or subthemes were incorporated iteratively.

RESULTS: Of 4,352 articles screened, data from 26 studies were included, all from a consumer perspective. All APA defined themes had supporting data, with most data coded as engagement styles (N=23 studies), background and accessibility (N=16), and privacy and security (N=13). Subthemes which frequently emerged were customizability (N=7) and preference for features within (N=22), including anxiety management (N=9) and psychoeducation (N=5) tools. The need for internet access (N=6) and cost concerns (N=5) were identified as barriers to use of DMHT and affected their perceived value. No new themes emerged; however, novel subthemes included discreetness of DMHT to avoid stigma.

CONCLUSIONS: All APA defined themes had supporting data in the literature; however, it is important to consider that data were sourced from heterogenous populations. The lack of data identified from an employer or payer valuation perspective highlights an important gap warranting future research.