Engagement of people with lived experience in the design and development of digital mental health interventions: a scoping review of engagement characteristics and impacts

Background: Digital mental health interventions (DMHIs) aim to increase access to mental healthcare for people who would otherwise not access it. Accordingly, the design and development of DMHIs may particularly benefit from engaging people with lived experience (PwLE). Methods: A scoping review involving systematic database searches identified and synthesised original research reporting PwLE engagement in the design and development of DMHIs (published January 2000– April 2024). Articles were independently title/abstract screened by two authors, and full-text screened by one author. Included article data were extracted, independently checked, and descriptively synthesised. Results: Twenty-nine studies were included, published 2012–2024, in high-income countries. Engagement was mostly via ‘consultation’ level activities (e.g., focus groups), followed by ‘involvement’ or ‘collaboration’. In almost half of studies, engagement spanned multiple engagement levels across the different development stages. Reported impacts included changes to content, design, and delivery (e.g., revised language). Authors credited engagement with improved DMHI relevance, acceptability, and inclusivity, while noted challenges include limited diversity among engaged PwLE and resource demands. For reported DMHI outcomes, studies reported positive findings related to use, and attitudes towards using DMHIs. However, reported findings were more mixed for mental health outcomes (e.g., symptom improvement). Additionally, it was not possible to directly link outcomes to PwLE engagement. Conclusions: Review findings highlight the increasing but predominantly consultative engagement of PwLE in developing DMHIs. Future research directions include more transparent and consistent reporting of engagement, deliberative decision-making around engagement levels/types, and more rigorous evaluation of engagement to investigate its association with DMHI outcomes.