If you are in distress, you can call or text 988 at any time. If it is an emergency, call 9-1-1 or go to your local emergency department.

Assessment Framework for Mental Health Apps

5. Usability and Accessibility Standards

This section considers the design and development of the app, and whether it follows any recognized application design standards, such as WC3, WCAG 2.0 AA, WCAG 2.1 AA, ISO 9241, Apple HIG, or Android Application Quality Guidelines. The review also considers whether there was any user involvement during the development of the app, user involvement in testing, or if any features were based on user feedback.

 

Criteria

Criteria Origin

5a — Q1

Is there a statement within the application outlining compliance with any currently recognized application design standards?

  • WC3
  • WCAG 2.0 AA
  • WCAG 2.1 AA
  • ISO 9241
  • Apple HIG
  • Android Application Quality Guidelines
  • ISO 25062
  • MAUQ
  • ADA
  • AODA

MHCC

5a — Q2

Is there a statement about lived and living experience feedback during design/development?

Guidance:

This criterion is to determine if relevant feedback from those with lived and living experience had been considered in the design of the app, before or after the app was released.

ORCHA

5a — Q3

Was the app co-designed by one or more people with lived and living experience?

MHCC

5a — Q4

Is there a statement about lived and living experience feedback from a community organization/online community during design/development?

Guidance:

This criterion is to determine if relevant feedback from a community organization/online community from those with lived and living experience had been considered in the design of the app, before or after the app was released. This criterion follows 5a-Q2 to remove the risk of biased feedback and encourage developer’s to reach out to communities.

MHCC

5a — Q5

Is there any evidence of lived and living experience involvement in testing?

MHCC

5a — Q6

Was user testing carried out with the relevant population the product has been designed for?

MHCC

5a — Q7

Has any user testing considered a diverse range of participants, with regards to differing cultures and demographics?

MHCC

5a — Q8

Has user testing considered participant differences in language?

MHCC

5a — Q9

Has user testing considered participant differences in gender?

MHCC

5a — Q10

Has user testing considered participant differences in sexual orientation?

MHCC

5a — Q11

Has user testing considered participant differences in race?

MHCC

5a — Q12

Has user testing considered participant differences in ethnicity?

MHCC

5a — Q13

Has user testing considered participant differences in religion?

MHCC

5a — Q14

Has user testing considered participant differences in spirituality?

MHCC

5a — Q15

Is there evidence of continuing to work with or include people with lived and living experience in the product’s development?

MHCC

5a — Q16

Is the app continuously developed, supported, and maintained?

MHCC

5a — Q17

Has the developer detailed their approach to continuous development, including reviewing their feedback?

ORCHA

5a — Q18

Does the detailed approach include key evaluative measures and/or indicators?

MHCC

5a — Q19

Does the developer have a post-release schedule or indicate how frequently they look at the need for changes?

ORCHA

5a — Q20

Has the developer indicated their process for reviewing content to ensure that it is aligned with up-to-date clinical guidelines?

ORCHA

Accessibility is important to consider, given that the application should be accessible to all users regardless of their specific needs. The review considers whether the application is customizable to suit certain needs, such as poor sight or hearing impairment. If the application uses any specialist or medical terms, these should be clearly explained to the user.

 

Criteria

Criteria Origin

5b — Q1

Can the user change the font size in-app/does the application respond to device preferences? 

ORCHA

5b — Q2

Does the application provide support for users with poor sight?

ORCHA

5b — Q3

Does the application provide support for users with hearing difficulty?

ORCHA

5b — Q4

Are there any components of the app which can be used to operate without Wi-Fi?

MHCC

5b — Q5

Is the app suitable for low-bandwidth connections?

MHCC

Accessibility also relates to the usability of the app, including further customization options. The review identifies if the application has any functions to aid navigation, such as a home button, back button, help button, or search feature. If the application utilizes push or email notifications, the standards identify whether the user has options to manage these for their own preference or privacy, both at the application and device level. Finally, if there are any bugs identified, these will be flagged. If the application contains a forum, then we look for a statement to ensure that forum content is moderated.

 

Criteria

Criteria Origin

5c — Q1

Can the user change the presentation theme such as language?

ORCHA

5c — Q2

Are any medical, specialist, or technical terms explained clearly to the user?

ORCHA

5c — Q3

Does the application send push notifications?

ORCHA

5c — Q4

Does the application send email notifications?

ORCHA

5c — Q5

Does the user have options to manage the notification settings (push/email) within the application for convenience/privacy?

ORCHA

5c — Q6

Does the application inform the user how to manage notification settings for convenience/privacy (to prevent information being shown if the device is locked but on show)?

ORCHA

5c — Q7

Was there any evidence of bugs during the review?

ORCHA

Support is a key area, since it is important that users know how to contact the developer if they have any problems or questions with the application. The standards also identify what type of support is offered to users, and if there is a commitment from the developer to respond to any user queries. We would expect to see that the type of support offered is appropriate to the application complexity; that is, a higher complexity application would require a more sophisticated offer of user support.

 

Criteria

Criteria Origin

5d — Q1

If there is a forum, is there a statement within the application that the forum content is moderated?

ORCHA

5d — Q2

Is there a statement about how to report technical issues to the developer?

ORCHA

5d — Q3

What kind of support is offered?

  • email address
  • live chat/chatbot
  • eTicket
  • helpline/telephone number

ORCHA

5d — Q4

Can the user contact other users for peer support?

MHCC

5d — Q5

Does the application provide technical support, therapeutic support, or both?

MHCC

5d — Q6

If therapeutic support is provided, is the application transparent regarding who this is provided by?

MHCC

5d — Q7

If therapeutic support is provided, is there a commitment from the app developer in terms of a time scale for response?

MHCC

5d — Q8

Is there any statement within the application about the developer’s commitment to addressing problems reported to them (e.g., time scales to respond, commitment to eradicate reported bugs and faults)?

ORCHA

5d — Q9

Is there a help feature accessible from every page of the app (e.g., an information button)?

MHCC

5d — Q10

Is there a clear, universally recognized help icon such as a question mark? 

MHCC

5d – Q11

Does the app collect user feedback through an appropriate channel?

Guidance:

An appropriate channel requires a formalized process (reviews from the Apple App Store or Google Play Store would not suffice).

MHCC