JMIR Publications

JMIR Mental Health


Currently submitted to: JMIR Mental Health

Date Submitted: Sep 26, 2017
Open Peer Review Period: Sep 26, 2017 - Nov 21, 2017

NOTE: This is an unreviewed Preprint

Peer-Review Me

Youth Co-design Of A Mobile Phone app to facilitate self-monitoring and management of mood symptoms in young people with major depression, suicidal ideation and self-harm

  • Sarah Elisabeth Hetrick; 
  • Jo Robinson; 
  • Eloise Burge; 
  • Ryan Blandon; 
  • Bianca Mobilio; 
  • Simon M Rice; 
  • Magenta B Simmons; 
  • Mario Alvarez-Jimenez; 
  • Simon Goodrich; 
  • Christopher G Davey



Effective treatment of depression in young people is critical given its prevalence, impacts and link to suicide. Clinical practice guidelines point to the need for regular monitoring of depression symptom severity and the emergence of suicidal ideation, to track treatment progress and guide intervention delivery. Yet, this is seldom integrated in clinical practice.


We aimed to address the gap between guidelines about monitoring and real-world practice by co-designing an app with young people that allows for self-monitoring of mood and communication of this monitoring with a clinician.


We engaged young people aged 18 to 25 who had experienced depression, suicidal ideation and/or self-harm, as well as clinicians in a co-design process. We used a human centred co-design “design studio” methodology where young people designed the features of the app first individually and then as a group. This resulted in a minimal viable product design, represented through low fidelity hand drawn wireframes. Clinicians were engaged throughout the process via focus groups.


The app incorporated a mood monitoring feature with innovative design aspects that allowed customisation, and was named a ‘well-being tracker’ in response to the need for a positive approach to this function. Brief personalised interventions designed to support young people in the intervals between face-to-face appointments were embedded in the app and were immediately available via pop-ups generated by a back-end algorithm within the well-being tracker. Issues regarding the safe incorporation of alerts generated by the app into face-to-face clinical services were raised by clinicians (i.e., responding in a timely manner) and will need to be addressed in the full implementation of the app into clinical services.


The potential to improve outcomes for young people via technology-based enhancement to interventions is enormous. Enhancing communication between young people and their clinicians about symptoms and treatment progress, and increase access to timely and evidence based interventions are desirable outcomes. To achieve positive outcomes for young people using technology (app) based interventions, it is critical to understand an incorporate, in a meaningful way, the expectations and motivations of both young people and clinicians.