“That’s Kind of Sus(picious)”: The Comprehensiveness of Mental Health Application Users’ Privacy and Security Concerns
Abstract
1 Introduction
2 Related Work
2.1 Privacy and Security Risks and Concerns for People Suffering from Mental Illnesses
2.2 Data Privacy in MHAs
2.3 Expert Evaluation Criteria
2.3.1 Privacy Not Included.
2.3.2 One Mind PsyberGuide.
3 Phase 1: MHA User Review Thematic Analysis
3.1 Phase 1 Methods
3.1.1 Selection of Sample Apps.
3.1.2 Data Collection and Analysis.
3.2 Phase 1 Findings
3.2.1 Types of Data Being Collected.
3.2.2 Third Party Involvement.
3.2.3 Data Safety: Mishandling data.
3.2.4 Data Safety: Lacking security measures.
3.2.5 Agency: Ownership of the data.
3.2.6 Agency: Manipulative data practices.
4 Phase 2: Comparison of MHA Users’ Privacy AND Security Concerns to Those Identified by Experts
4.1 Comparison of User to Expert Concerns
4.2 Phase 2 Findings
MHA USER CONCERNS | MHA EXPERT CONCERNS | ||
Unnecessary, invasive, or identifying data collection | Collecting more data than is necessary* | ||
Data sharing/selling with third parties | Company can share or sell data with third parties* | ||
Data used for ads | Data used for advertisement or for commercial purposes* | ||
Unable to access personal information | Unclear or users can’t request access to the data collected | ||
Unable to delete personal information or payment information | Unclear or users can’t delete their data* | ||
Lack of transparency about data storage | Doesn’t explain how long they retain users’ data | ||
Prior major security vulnerabilities | |||
Data breach | Prior data leaks | ||
Lacking encryption | Lacks encryption | ||
Lacks automatic security updates | |||
Doesn’t require strong passwords | |||
Lacking protection for minors, preying vulnerabilities | Doesn’t manage vulnerabilities | ||
Unable to contact the company regarding privacy policy | No publicly available privacy policy/contact (transparency)* | ||
Unauthorized data tracking | Device could facilitate spying | ||
Invasive data tracking/monitoring or unnecessary data tracking | Permissions requested inappropriate | KEY | |
Manipulative data practices | <1% | ||
HIPAA violation, health data collection | 1-10% | ||
Unable to control data selling, turn off data tracking, opt-out of emails | 10-20% | ||
Lacking security settings | >20% | ||
4.2.1 Where user concerns aligned with the expert criteria.
4.2.2 Where users did not mention expert criteria.
4.2.3 Where users had concerns that were not being evaluated by experts.
5 Discussion
5.1 Implications for Better MHA User Guidance and Education
5.2 Limitations
5.3 Future Work
6 Conclusion
Acknowledgments
A Appendix
A.1 Supplementary Table
App Name | App Store | Number of User Reviews After Exclusion | Number of Relevant Reviews |
---|---|---|---|
Cerebral - Mental Health | Apple App Store, Google Play | 927, 103 | 16, 13 |
Replika -Virtual AI Companion | Apple App Store, Google Play | 1000, 430 | 29, 9 |
Youper - CBT Therapy Chatbot | Apple App Store, Google Play | 902, 608 | 2, 26 |
BetterHelp - Therapy | Apple App Store, Google Play | 1000, 625 | 10, 15 |
Sensa | Apple App Store, Google Play | 396, 649 | 8, 15 |
Insight Timer - Meditation App | Apple App Store, Google Play | 995, 281 | 17, 4 |
Headspace: Mindful Meditation | Apple App Store, Google Play | 1000, 107 | 6, 11 |
7 Cups: Online Therapy & Chat | Apple App Store, Google Play | 29, 579 | 9, 5 |
Breeze: Mental Health | Apple App Store, Google Play | 772, 401 | 10, 3 |
Fabulous Daily Routine Planner | Apple App Store, Google Play | 1000, 315 | 9, 4 |
Aura: Meditation & Sleep | Apple App Store, Google Play | 837, 371 | 4, 6 |
Clarity - CBT Thought Diary | Apple App Store, Google Play | 518, 417 | 8, 2 |
Ginger Emotional Support | Apple App Store, Google Play | 388, 536 | 7, 3 |
Talkspace Counseling & Therapy | Google Play | 694 | 10 |
Me+ Daily Routine Planner | Apple App Store | 702 | 9 |
Mood Tracker Journal | Google Play | 97 | 9 |
Bloom: CBT Therapy & Journal | Apple App Store | 715 | 8 |
Calm | Apple App Store, Google Play | 999, 169 | 3, 5 |
Daylio Journal - Daily Diary | Apple App Store | 452 | 8 |
Feelsy: Stress Anxiety Relief | Apple App Store, Google Play | 599, 519 | 2, 6 |
Inflow - Manage your ADHD | Apple App Store | 241 | 8 |
Sanvello: Anxiety & Depression | Apple App Store, Google Play | 556, 651 | 7, 1 |
stoic. journal & planner | Apple App Store | 796 | 8 |
MindDoc: Your Companion | Apple App Store, Google Play | 396, 266 | 2, 5 |
VOS: Wellbeing Plan & Journal | Google Play | 281 | 7 |
Balance: Meditation & Sleep | Apple App Store, Google Play | 831, 475 | 0, 6 |
Jumping Minds - Feel Better | Google Play | 463 | 6 |
Woebot: Your Self-Care Expert | Apple App Store, Google Play | 990, 586 | 2, 4 |
BetterMe: Mental Health | Apple App Store, Google Play | 267, 310 | 1, 4 |
Breethe - Meditation & Sleep | Apple App Store, Google Play | 565, 297 | 5, 0 |
MindShift CBT - Anxiety Relief | Apple App Store, Google Play | 85, 112 | 4, 1 |
The Tapping Solution | Apple App Store, Google Play | 686, 420 | 1, 4 |
NOCD: OCD Therapy and Tools | Apple App Store | 70 | 4 |
PTSD Coach | Google Play | 100 | 4 |
Rootd - Panic Attack Relief | Apple App Store | 246 | 4 |
Sleep | Apple App Store | 351 | 4 |
Remente: Self Care & Wellbeing | Apple App Store, Google Play | 16, 404 | 0, 4 |
Wisdo: Mental Health & Support | Apple App Store, Google Play | 80, 145 | 3, 1 |
29k: Mental Health & Wellbeing | Apple App Store, Google Play | 45, 120 | 0, 3 |
AbleTo | Apple App Store, Google Play | 36, 30 | 2, 1 |
How We Feel | Apple App Store | 364 | 3 |
Journal Diary | Apple App Store | 59 | 3 |
Loóna: calm, relax and sleep | Apple App Store | 967 | 3 |
Silk + Sonder Guided Self-Care | Apple App Store | 105 | 3 |
Reflectly - Journal & AI Diary | Apple App Store, Google Play | 1000, 198 | 1, 2 |
ReGain - Couples Therapy | Apple App Store | 537 | 3 |
Therapeer: Peer Support Groups | Apple App Store | 143 | 3 |
Alan Mind Daily Journal | Apple App Store | 391 | 2 |
Anxiety & Sleep: Urban Health | Google Play | 151 | 2 |
being: my mental health ’map’ | Google Play | 528 | 2 |
DBT Coach : Guided Therapy | Google Play | 60 | 2 |
Finch: Self Care Pet | Apple App Store, Google Play | 1000, 519 | 1, 1 |
Medito: Meditation & Sleep | Apple App Store, Google Play | 210, 113 | 2, 0 |
Mood Balance:Self Care Tracker | Apple App Store | 492 | 2 |
Moodnotes - Mood Tracker | Apple App Store | 267 | 2 |
Shmoody: Improve Your Mood | Apple App Store, Google Play | 71, 361 | 1, 1 |
Sleep Sounds - relaxing sounds | Google Play | 201 | 2 |
TalkLife | Apple App Store, Google Play | 203, 694 | 2, 0 |
App Name | App Store | Number of User Reviews After Exclusion | Number of Relevant Reviews |
---|---|---|---|
Amaha (InnerHour): self-care | Google Play | 348 | 1 |
Anxiety Tracker-Log & Analyze | Google Play | 81 | 1 |
Bearable - Symptom Tracker | Apple App Store | 218 | 1 |
CBT Companion: Therapy App | Apple App Store, Google Play | 58, 726 | 0, 1 |
Elomia: AI Therapy Chat | Apple App Store | 44 | 1, 0 |
Evolve: Self-Care & Meditation | Google Play | 456 | 1 |
Grid Diary - Journal, Planner | Apple App Store | 54 | 1 |
HarmLess: Self Harm Tracker | Apple App Store | 198 | 1 |
Humans Anonymous | Apple App Store | 137 | 1 |
Intellect: Create A Better You | Google Play | 135 | 1 |
Mind journal: Diary, Mood trac | Google Play | 592 | 1 |
Mindbliss - Meditation & Sleep | Apple App Store | 12 | 1 |
MindPeers- For Mental Strength | Google Play | 420 | 1 |
MINDSET by DIVE Studios | Apple App Store, Google Play | 674, 141 | 1, 0 |
Moodfit: Mental Health Fitness | Apple App Store, Google Play | 88, 284 | 0, 1 |
MoodSpace - Stress, anxiety, & | Google Play | 21 | 1 |
Neurocycle | Apple App Store | 305 | 1 |
Nguvu Health: Therapy for all | Google Play | 43 | 1 |
OCD.app - Anxiety Mood & Sleep | Apple App Store, Google Play | 58, 41 | 0, 1 |
Pride Counseling | Apple App Store | 135 | 1 |
Real: Mental Health | Apple App Store | 52 | 1 |
Sleepiest: Sleep Meditations | Apple App Store | 612 | 1 |
SOS Method: Stress & Anxiety | Google Play | 418 | 1 |
ThoughtFullChat: Mental Health | Google Play | 68 | 1 |
Wysa: Anxiety, therapy chatbot | Apple App Store, Google Play | 637, 351 | 1, 0 |
Aetheria | Apple App Store | 12 | 0 |
Amaru: Self-care Virtual Pet | Apple App Store | 226 | 0 |
Better Sleep with KindMind | Apple App Store | 20 | 0 |
Bold: CBT Therapy Journal | Apple App Store | 29 | 0 |
buddhify - mindfulness meditation on the go | Apple App Store, Google Play | 81, 361 | 0, 0 |
Callie: All-In-One Self Care | Apple App Store | 61 | 0 |
Calm Harm – manage self-harm | Apple App Store, Google Play | 55, 28 | 0, 0 |
Calm Urge: Self Harm Tracker | Apple App Store | 72 | 0 |
CareMe Health - Mental Health | Google Play | 340 | 0 |
Cheerly: Daily Wellness Game | Google Play | 513 | 0 |
Dare: Anxiety & Panic Attacks | Apple App Store, Google Play | 256, 314 | 0, 0 |
Deep Sleep with Andrew Johnson | Google Play | 302 | 0 |
DiveThru | Apple App Store | 36 | 0 |
eMoods Bipolar Mood Tracker | Apple App Store | 70 | 0 |
Emotion Tracker : Self Care | Apple App Store | 27 | 0 |
Flow - Depression treatment | Google Play | 206 | 0 |
HeadHelp: Self Care & Vent | Apple App Store | 238 | 0 |
Hector: AI Therapist/Therapy | Apple App Store | 46 | 0 |
heyy, your mental health guide | Google Play | 4 | 0 |
Hiwell Therapy & Mental Health | Google Play | 36 | 0 |
HopeQure: Counseling & Therapy | Google Play | 500 | 0 |
Iona: Mental Health Support | Google Play | 350 | 0 |
JoyScore: Joy & Self-Care Tool | Apple App Store | 51 | 0 |
Meomind - Listen to therapy | Google Play | 352 | 0 |
Mindfulness Coach | Google Play | 245 | 0 |
Mindfulness Meditation. | Apple App Store | 507 | 0 |
Mindllama breathe to relax | Apple App Store | 160 | 0 |
Mindshine: Mental Health Coach | Google Play | 14 | 0 |
Mindspa: The Mental Health App | Google Play | 30 | 0 |
App Name | App Store | Number of User Reviews After Exclusion | Number of Relevant Reviews |
---|---|---|---|
Mood Journal: emotions tracker | Google Play | 288 | 0 |
Moodistory - Emotion Tracker | Apple App Store | 43 | 0 |
MoodKit | Apple App Store | 29 | 0 |
MoodTools - Depression Aid | Google Play | 414 | 0 |
MyPossibleSelf: Mental Health | Google Play | 21 | 0 |
Norbu: Stress management | Google Play | 402 | 0 |
Now&Me - Therapy, Counselling | Google Play | 37 | 0 |
Numo: Cringe-Free ADHD App | Apple App Store | 67 | 0 |
Online Therapy & Counseling | Google Play | 25 | 0 |
Online therapy, emotional help | Google Play | 34 | 0 |
Pi Journal: anxiety relief the | Google Play | 203 | 0 |
PursueCare | Google Play | 388 | 0 |
ShareSpace:Vent&Care Community | Google Play | 49 | 0 |
Simple Habit: Meditation | Google Play | 48 | 0 |
Skylight: Spiritual Self-Care | Google Play | 201 | 0 |
Sleep Sounds - Relax Music | Google Play | 142 | 0 |
Tellmi: Better Mental Health | Google Play | 425 | 0 |
The Hopeful | Daily Self-Care | Apple App Store | 308 | 0 |
uMore - mental health tracker | Google Play | 32 | 0 |
Unmind | Google Play | 39 | 0 |
Unwinding Anxiety® | Google Play | 155 | 0 |
UP! - Depression, Bipolar & Bo | Google Play | 141 | 0 |
Voice – Mental Health Guide | Google Play | 238 | 0 |
What’s Up? - Mental Health App | Apple App Store, Google Play | 28, 109 | 0, 0 |
WhiteFlag Mental Health App | Google Play | 77 | 0 |
WHY Emotional Support &Therapy | Google Play | 38 | 0 |
WorryTree: Anxiety Relief CBT | Google Play | 42 | 0 |
Zen: Guided Meditation & Sleep | Apple App Store | 116 | 0 |
Theme | Subthemes | Codes |
---|---|---|
3rd party involvement | data selling to marketers, data sharing with partner without consent, data used for marketing, data sharing with third parties, data used for ads, data used for research, data sharing, data selling, government used, sharing data with third parties | |
Data safety | Mishandling data | hacking, data breach, data handled by people they don’t know, data leaks, data stealing, data loss due to policty changes, privacy invaded by algorithms |
Lacking security measures | lacking encryption, lacking protection for minors, lacking security settings, blocked by anti-virus software, preying vulnerabilities, confidentiality | |
Data Type Collected | Data tracking | data tracking across other apps, anti-privacy tracker, invasive data tracking, invasive data monitoring, unnecessary data tracking, unauthorized data tracking |
Data collection | unnecessary data collection, invasive data collection, identifying data collection, more data collection due to policy changes | |
Personal health information | Personal health information, hipaa violation | |
Agency | Ownership of the data | unable to access personal information, unable to cancel the account, unable to control data selling, unable to delete card information, unable to delete messages, unable to delete personal information, unable to edit personal information, unable to opt-out of emails, unable to delete entries, unable to remove partner from the account, unable to turn off data tracking |
Manipulative data practices | lack of transparency about data handling, lack of transparency about data storage, lack of transparency about data usage, unable to contact the company regarding privacy policy | |
Deceptive data gathering: create an account, data storing, forced permission, mandatory data collection, not following thier policy | ||
Unethical data usage: data hostage, insurance fraud, unauthorized charges, under investigation, not following thier policy |
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