A Structured Mixed-Methods Workflow for User-Centred Digital Mental Health Platform Design

Digital mental health interventions (DMHIs) frequently experience low user engagement and high attrition, highlighting the importance of incorporating user-centred design approaches during early-stage development. This study presents a structured mixed-methods workflow that integrates participatory co-design activities with a complementary quantitative prototype evaluation to support the formative development of digital mental health platforms. Using a qualitatively driven sequential design with an embedded quantitative strand, 45 university students in design, engineering, architecture and ergonomics programmes took part in three participatory co-design workshops in nine groups of five and, at the close of the final session, each group rated the low-fidelity AMGR-I prototype it had itself built against eleven design criteria. Ratings differed systematically across criteria (Friedman χ2(10) = 225.73, p < 0.001, Kendall’s W = 0.50), and the difference persisted when the clustering of ratings within the nine artefacts was modelled. Gamification was rated significantly lower than every other criterion after Holm’s correction and content quality highest, while data privacy and security was among the lowest-rated criteria despite being one of the most frequently and forcefully discussed concerns in the workshops. Because the instrument measured evaluation of the artefact rather than the importance attached to each criterion, that pattern is a convergence between the two strands rather than a paradox: the requirement these participants discussed most was the one their own artefacts served worst. That convergence is the study’s central integrated finding. The participants are characterised throughout as design-literate formative evaluators rather than as prospective users, and the resulting design propositions are presented as hypotheses for subsequent testing. The contribution of the paper is the workflow itself: a lightweight, low-cost and classroom-deployable procedure for combining co-design with structured prototype evaluation at the pre-clinical formative stage.