Needs and Expectations for the myNewWay Blended Digital and Face-to-Face Psychotherapy Model of Care for Depression and Anxiety (Part 1): Participatory Design Study including People with Lived and Living Experience.

Background: Digital mental health interventions (DMHIs) are effective in reducing symptoms of depression and anxiety. Low user engagement and uptake of DMHIs observed in previous research may be addressed by involving the intended target audience in the design of the DMHI from the outset.

Objective: This study is phase 1 of a multiphase project aimed at designing, developing, and evaluating a blended DMHI for depression and anxiety in Australia. Our objective was to partner with adults with lived and living experiences of depression and anxiety on their needs and expectations of a new transdiagnostic DMHI for depression and anxiety. This included identifying strategies that would help increase their engagement with the DMHI and their preferences for integrating the DMHI with psychotherapy.

Methods: A mixed methods participatory design approach was used to collect quantitative and qualitative data via a web-based survey (n=324) and semistructured interviews (n=21). Feedback was collected on participants' needs and expectations for the DMHI, including accessibility, content, features, functionality, format, data sharing, preferred clinical support pathways, and barriers to and facilitators of user engagement. Qualitative interview data were analyzed using reflexive thematic analysis.

Results: Most participants (190/257, 73.9%) preferred a DMHI delivered as a smartphone app that could be used at any time of the day. Ease of use and a well-designed interface were important, as was a positive, encouraging, and uplifting DMHI look and feel. Other preferences included symptom tracking, diverse therapeutic content, and features that facilitated social connection and peer support (eg, online community and stories of lived and living experience). Participants also suggested several strategies to enhance engagement with the DMHI, including personalization, reminders, short and achievable activities, and goal setting. Participants reported a strong interest in sharing information from their DMHI with mental health professionals (to facilitate therapy), especially regarding changes to their emotions.

Conclusions: Transdiagnostic DMHIs for depression and anxiety have great potential to improve access to affordable, evidence-based mental health support. Involving people with lived and living experiences of depression and anxiety in the design, development, and conceptualization of DMHIs may improve uptake, acceptance, engagement, usability, and ultimately, treatment outcomes.