Framework to Assist Stakeholders in Technology Evaluation for Recovery (FASTER) to Mental Health and Wellness

Smisha Agarwal; Madhu Jalan; Rachel Hill; Emily Pantalone; Johannes Thrul; Ritu Sharma; Holly C Wilcox; Karen A Robinson

doi:10.1186/s12913-025-12418-0

Framework to Assist Stakeholders in Technology Evaluation for Recovery (FASTER) to Mental Health and Wellness

BMC Health Serv Res. 2025 Apr 30;25(1):623. doi: 10.1186/s12913-025-12418-0.

Authors

Smisha Agarwal^{1

2}, Madhu Jalan³, Rachel Hill⁴, Emily Pantalone⁴, Johannes Thrul^{5

6

7}, Ritu Sharma^{8

9}, Holly C Wilcox^{5

9}, Karen A Robinson^{8

10

9

11}

Affiliations

¹ Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. sagarw23@jhu.edu.
² Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA. sagarw23@jhu.edu.
³ Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
⁵ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
⁶ Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
⁷ Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
⁸ Johns Hopkins University Evidence-Based Practice Center, Johns Hopkins Medicine, Baltimore, MD, USA.
⁹ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁰ Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Abstract

Mental health mobile applications (apps) have the potential to expand the provision of mental health and wellness services to underserved populations. There is a lack of guidance on how to choose wisely from the thousands of mental health apps without clear evidence of safety, efficacy, and consumer protections. We propose the Framework to Assist Stakeholders in Technology Evaluation for Recovery (FASTER) to Mental Health and Wellness to support agencies and individuals working in mental health, as well as users of mental health apps, in making informed decisions recommending the use of, or using mental health and wellness apps. The framework was developed through a systematic process including a review of existing frameworks and the literature, interviews with key informants, public stakeholder feedback, and iterative application and refinement of the framework to 45 apps. It comprises three sections: Section 1. Risks and Mitigation Strategies, assesses the integrity and risk profile of the app; Section 2. Function, focuses on descriptive aspects related to accessibility, costs, developer credibility, evidence and clinical foundation, privacy/security, usability, functions for remote monitoring of the user, access to crisis services, and artificial intelligence (AI); and Section 3. Mental Health App Features focuses on specific mental health app features, such as journaling and mood tracking. The framework facilitates an assessment of the level of risk posed by the app against the evidence on the effectiveness of the app and its safety features, recognizing that given vast variations in health apps, a 'one size fits all' approach is likely to be insufficient. Future application, testing, and refinements may be required to determine the framework's suitability and reliability across multiple mental health conditions.

Keywords: Digital Health; Effectiveness; Mental Health; Safety; Technology Evaluation.

MeSH terms

Humans
Mental Disorders* / therapy
Mental Health
Mental Health Services*
Mobile Applications* / standards
Stakeholder Participation*
Technology Assessment, Biomedical* / methods
Telemedicine