Understanding Engagement With Digital Mental Health Technology in Mental Health Services: Multicenter Observational Study

This study reveals that both individual- and service-level factors significantly influence DMHT engagement, with the service center being the strongest predictor. This highlights the importance of service-level technology integration and support roles, such as digital navigators, in fostering engagement. Significant variation in engagement among user groups indicates the need for a nuanced approach to measurement-based care. While mental illness generally did not impede engagement, self-perceived severity and anxiety symptoms were barriers. These findings underscore the critical importance of systemic factors and service-level integration strategies in driving DMHT engagement. User-centered designs remain important, but effective integration of DMHTs into existing mental health services is paramount for improving engagement across diverse user groups and clinical presentations. This multilevel approach, encompassing individual, service, and system-wide considerations, is essential for realizing DMHTs' full potential in delivering effective measurement-based care.