Christian Korthé Carlsen’s research while affiliated with Region of Southern Denmark and other places

UNSTRUCTURED Digital mental health solutions have great potential to enhance mental healthcare. However, barriers at the level of users, interventions and context hinder engagement and uptake. Involving users in the design, adaptation and implementation process has been put forward as a potential solution, yet instructions and examples on how to do so are limited. One potential framework is design thinking. Although design thinking is a common approach in the business community, its use for guiding development and adaptation processes is not yet common practice in the context of digital mental health. Unsurprisingly, it is difficult to find concrete instructions on how to do this, even more so in an international context. Therefore, the Successful User Participation Examples and Recommendations (SUPER) project aimed to develop guidelines for entrepreneurs and mental health organizations on how to involve end-users and mental health professionals in the transnational development, implementation and adaptation of mental health technology. This paper describes the steps of design thinking and how these can be undertaken by researchers, practitioners or developers in the context of digital mental health. The process is illustrated with two adaptations of digital mental health solutions following this approach, executed by the SUPER consortium in the Netherlands and in Denmark. The learnings from these two pilots are provided in the form of key considerations and highlights of issues that were experienced during both design thinking processes. The overall aim is to guide practitioners, developers and researchers towards better development and international adaptation of digital mental health.

Increased user participation in developing and adapting digital mental health solutions helps to tackle barriers and enhance facilitators for uptake of and engagement with digital mental health solutions. These guideline aims to aid this process of involving and empowering the intended users and provide a practical step-by-step guide to better understand and include them in a meaningful way. To do so, we will elaborate on the importance and concept of this participation. Then, we will present Design Thinking as a process framework, referring to methods you can use for user participation throughout the process. To provide depth, the guidelines incorporate insights from transnational adaptations of two digital mental health solutions: the Stress Autism Mate (SAM) app and the SAFE app. These real-world examples highlight the challenges and successes encountered when scaling solutions across cultural contexts. Finally, we summarise our recommendations in concrete topics you should be aware of when working with user participation for digital mental health innovation in an international context.