Mobile Mental Health Applications for American Indian and Alaska Native Communities: Review and Recommendations

American Indian/Alaska Native (AI/AN) communities experience high rates of several mental health (MH) difficulties (e.g., trauma, substance use, suicide) and encounter significant barriers to accessing MH care. Several barriers relate to rural residence (e.g., geographical distance to healthcare facilities, provider shortages) and cultural factors (e.g., racial discrimination, cultural misunderstandings, mistrust). Remotely delivered care via telehealth has demonstrated promise in increasing AI/AN communities’ access to MH care, but provider shortages limit scalability. Mobile MH applications (“apps”) may represent a scalable option for increasing AI/AN communities’ access to MH interventions but need to be culturally tailored to address cultural barriers to MH care. Although additional research is needed, several MH apps have demonstrated promise in addressing MH concerns (e.g., depression, anxiety). Few MH apps have been developed or evaluated for AI/AN communities, and greater attention to the development of MH apps for them is needed. Several models exist for evaluating MH apps, but they have not been applied to apps for AI/AN communities. This article provides guidance on factors to consider when developing apps for AI/AN communities, based on a review of the literature and existing apps for AI/AN communities. Some recommendations include using a bidirectional approach rooted in humility and cultural safety principles to promote mutual learning and patient-centered care. Partnering with AI/AN communities in developing MH apps is vital. These recommendations also may be valuable for those serving additional populations experiencing healthcare inequities and cultural barriers to MH care.