A Bibliometric Mapping of mHealth Application in University Mental Health Policy and Practice
Abstract
Introduction: Mental health issues among university students are becoming increasingly prevalent and have a significant impact on academic performance and overall well-being. In response, mobile health (mHealth) applications and digital psychometric tools have emerged as promising solutions for expanding access to mental health support. However, challenges remain in terms of effectiveness, user engagement, long-term scalability, and integration into institutional frameworks and policy systems.
Methods: This study conducts a comprehensive bibliometric analysis using three established techniques co-citation analysis, bibliographic coupling, and co-word analysis to examine the evolution of digital mental health research in higher education. These complementary methods collectively provide a triangulated understanding of intellectual foundations, thematic development, and conceptual trends. Data were retrieved from the Scopus database, filtered for relevance, and visualized using VOSviewer software to identify key themes, conceptual structures, and research trends.
Results: The analysis identified four major co-citation clusters centered on psychometric tools and digital intervention strategies, three bibliographic coupling clusters highlighting challenges in engagement and implementation, and five Co-word clusters representing emerging research areas such as mindfulness apps, resilience, and digital literacy. Findings reveal growing interdisciplinary collaboration, yet highlight persistent barriers in user adherence, cultural adaptation, and policy development.
Conclusion: The study provides a structured overview of current research on digital mental health interventions in higher education, uncovering gaps in policy integration and long-term effectiveness. It offers practical insights for educators, healthcare professionals, and policymakers seeking to develop sustainable, evidence-based mental health strategies. Moving forward, institutions must focus on inclusive design, ethical data use, and institutional readiness to enhance the impact and scalability of digital mental health tools.
References
Bruffaerts R, Mortier P, Kiekens G, Auerbach RP. Mental Health Problems in College Freshmen: Prevalence and Academic Functioning. J Affect Disord. 2018;January 01:97–103.
Agnafors S, Barmark M, Sydsjö G. Correction : Mental health and academic performance : a study on selection and causation effects from childhood to early adulthood. Soc Psychiatry Psychiatr Epidemiol. 2024;59(1):199.
Segar PAPG, Kosnin ABM. Influencing Factors , Academic Impacts , and Effective Evidence-Based Interventions for University and College Students ’ Mental Health : A Systematic Review. Int J Acad Res Bus Soc Sci. 2024;14(9).
Kang-Yi CD, Arnold KT, Tieu T, Olubiyi O, Xie M, Lawson GM, et al. The relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders. Clin Child Psychol Psychiatry. 2023 Jul;29(1):103–15.
Atkins MS, Hoagwood KE, Kutash K, Edward Seidman. Toward the Integration of Education and Mental Health in Schools. Adm Policy Ment Heal. 2010;37 (1-2):40–7.
Goodwin J, Savage E, O’Brien N, O’Donovan A. “ We ’ re not educated on that enough , and we really should be ”: adolescents ’ views of mental health service education. Int J Qual Stud Health Well-being. 2023;18(1).
Ross A-S, Wang C, Liu JL. Youth mental health first aid training with diverse educators. Psychol Serv. 2023 Nov;20(4):941–51.
Gray C, Wilcox G, Nordstokke D. Teacher Mental Health , School Climate , Inclusive Education and Student Learning : A Review. Can Psychol. 2017;58(3):203–10.
Broglia E, Millings A. Student mental health profiles and barriers to help seeking : When and why students seek help for a mental health concern. Couns Psychother Res. 2021;21(June):816–26.
Avdija AS. Stress and law enforcers : testing the relationship between law enforcement work stressors and health-related issues. Heal Psychol Behav Med. 2014;2(1):100–10.
Beebe A. Barriers to Mental Health Service Access at a Large Public University. PSU McNair Sch Online J. 2017;11(2):0–24.
Schindler A, Polujanski S, Rotthoff T. A longitudinal investigation of mental health , perceived learning environment and burdens in a cohort of first-year German medical students ’ before and during the COVID-19 ‘ new normal .’ BMC Med Educ. 2021;1–11.
Id MK, Camacho E, Kwon S, Id JT. Exploring how informed mental health app selection may impact user engagement and satisfaction. PLOS Digit Heal. 2023;1–12.
Berman AH, Bendtsen M, Molander O, Lindfors P, Lindner P, Granlund L, et al. Compliance with recommendations limiting COVID-19 contagion among university students in Sweden : associations with self-reported symptoms , mental health and academic self-efficacy. Scand J Public Health. 2022;(September 2020):70–84.
Garrido S, Millington C, Cheers D, Boydell K, Schubert E, Meade T, et al. What Works and What Doesn ’ t Work ? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People. Front psychiatry. 2019;10(November):1–19.
Fürtjes S, Gebel E, Kische H. Characteristic of mental health app usage : a cross-sectional survey in the general population. BMC Public Health. 2024;1–11.
Baumel A, Muench F, Edan S, Kane JM, Ave AK. Objective User Engagement With Mental Health Apps : Systematic Search and Panel-Based Usage Analysis Corresponding Author : J Med Internet Res. 2019;21:1–15.
Davies EL, Gordon AL, Hooper KJ, Laing RE, Lynch EA, Pelentsov LJ, et al. Introducing the Needs in Recovery Assessment ( NiRA ) into clinical practice : protocol for a pilot study investigating the formal and systematic assessment of clinical and social needs experienced by service users at a tertiary , metropolitan mental heal. Pilot Feasibility Stud. 2021;1–8.
Subba P, Luitel NP, Kohrt BA, Jordans MJD. Improving detection of mental health problems in community settings in Nepal : development and pilot testing of the community informant detection tool. Confl Health. 2017;1–11.
Grant M, Petersen I, Mthethwa L, Luvuno Z, Bhana A. Accuracy of a community mental health education and detection ( CMED ) tool for common mental disorders in KwaZulu ? Natal , South Africa. Int J Ment Health Syst. 2022;7:1–9.
Agarwal AK, Southwick L, Gonzales RE, Bellini LM, Asch DA, Shea JA. Digital Engagement Strategy and Health Care Worker Mental Health A Randomized Clinical Trial. JAMA Netw Open. 2024;1–13.
Thakkar A, Gupta A, Sousa A De. Artificial intelligence in positive mental health : a narrative review. Front Digit Heal. 2024;(March):1–11.
Ashleigh G, Aboujaoude E. The Framework for AI Tool Assessment in Mental Health ( FAITA - Mental Health ): a scale for evaluating AI- powered mental health tools. World Psychiatry. 2024;(October):444–5.
Moore GF, Cox R, Evans RE, Hallingberg B, Hawkins J, Littlecott HJ. School , Peer and Family Relationships and Adolescent Substance Use , Subjective Wellbeing and Mental Health Symptoms in Wales : a Cross Sectional Study. Child Ind Res. 2018;1951–65.
Dietzel D, Synnott J, Ioannou M. Prison Mental Health Screening Tools: Updated Choices and Sensitivity. Assesment Dev Matters. 2022;26–9.
Perera C, Salamanca-sanabria A, Caballero-bernal J, Feldman L, Hansen M, Bird M, et al. No implementation without cultural adaptation : a process for culturally adapting low-intensity psychological interventions in humanitarian settings. Confl Health. 2020;1–12.
Knapp AA, Cohen K, Nicholas J, Mohr DC, Carlo AD, Skerl JJ, et al. Integration of Digital Tools Into Community Mental Health Care Settings That Serve Young People: Focus Group Study. JMIR Ment Heal. 2021 Aug;8(8):e27379.
Lim C, Fuchs C, Torous JB. Integrated Digital Mental Health Care: A Vision for Addressing Population Mental Health Needs. Int J Gen Med. 2024;17:359–65.
Kennedy BR, Rhodes NES-, Avendano JS, Mathew J, Brien KO, Chek CJW, et al. Resilience , Mindfulness , Anxiety , and Depression Within a Dual-Continua Model of Mental Health Approach. J Happines Heal. 2024;4(1):11–8.
Berardi C, Antonini M, Jordan Z, Wechtler H, Paolucci F, Hinwood M. Barriers and facilitators to the implementation of digital technologies in mental health systems : a qualitative systematic review to inform a policy framework. BMC Health Serv Res. 2024;1–19.
Maharani G, Jaya UP. Analisis Bibliometrik : Brand Management dan Customer Loyalty ( 2010 – Analisis Bibliometrik : Brand Management dan Customer Loyalty. J Ilm Manaj Ekon dan Akunt. 2024;(November 2023).
Rossetto DE, Bernardes RC, Borini FM, Gattaz CC. Structure and Evolution of Innovation Research in The Last 60 Years : Review and Future Trends in The Field of Business Through The Citations and Co-citations Analysis. Scientometrics. 2018;
Iriyani SA, Hadi HS, Nova E, Patty S. Analisis Bibliometrik dengan VOSViewer : Studi Artificial Intelegence dalam Pendidikan. J Simki Pedagog. 2023;6(2):339–49.
Herdianto R, Windyaningrum N, Masruroh B, Arif M. Filsafat Pendidikan dan Perkembangannya : Kajian Bibliometrik berdasarkan Database Scopus. Belantika Pendidik. 2021;(November).
McCain KW. Mapping Authors in Intellectual Space: A Technical Overview. J Am Soc Inf Sci [Internet]. 1990;41(6):433–43. Available from: https://www.taylorfrancis.com/books/9781136086946/chapters/10.4324/9780240817750-3
Leung XY, Sun J, Bai B. International Journal of Hospitality Management Bibliometrics of social media research : A co-citation and co-word analysis. Int J Hosp Manag. 2017;66:35–45.
Liu Z, Yin Y, Liu W, Dunford M. Visualizing the intellectual structure and evolution of innovation systems research : a bibliometric analysis. Scientometrics. 2015;(January).
Donthu N, Kumar S, Mukherjee D, Pandey N, Lim WM. How to conduct a bibliometric analysis: An overview and guidelines. J Bus Res [Internet]. 2021 Sep;133:285–96. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0148296321003155
Fauzi MA. Cyberbullying in higher education: a review of the literature based on bibliometric analysis. Kybernetes [Internet]. 2024 Aug 15;53(9):2914–33. Available from: https://www.emerald.com/insight/content/doi/10.1108/K-12-2022-1667/full/html
Budler M, Zupic I, Trkman P. The Development of Business Model Research : A Bibliometric Review The Development of Business Model Research : A Bibliometric Review Introduction. J Bus Res. 2021;(June).
van Eck NJ, Waltman L. Visualizing Bibliometric Networks. Measuring Scholarly Impact. 2014. 285–320 p.
Firth J, Torous J, Nicholas J, Carney R, Rosenbaum S, Sarris J. Can Smartphone Mental Health Intervention Reduce Symptoms of Anxiety? A Meta-Analysis of Randomized Controlled Trials. J Affect Disord. 2017;
Torous J, Nicholas J, Larsen ME, Firth J, Christensen H. Clinical review of user engagement with mental health smartphone apps : evidence , theory and improvements. Evid Based Ment Heal. 2018;21(3):1–4.
Spitzer RL, Kroenke K, Williams JBW, Löwe B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092–7.
Firth J, Torous J, Nicholas J, Carney R, Pratap A, Rosenbaum S, et al. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017;16(3):287–98.
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;46202:606–13.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.
Cohen S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress.pdf. J Health Soc Behav. 1983;24:385–96.
Lattie EG, Adkins EC, Winquist N, Stiles-Shields C, Wafford QE, Graham AK. Digital mental health interventions for depression, anxiety and enhancement of psychological well-being among college students: Systematic review. J Med Internet Res. 2019;21(7).
Kroenke K, Spitzer R. The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatr Ann. 2002 Sep;32:509–21.
Kern A, Hong V, Song J, Lipson SK, Eisenberg D. Mental health apps in a college setting : openness , usage , and attitudes. mHealth. 2018;(2).
Chandrashekar P. Do mental health mobile apps work : evidence and recommendations for designing high-efficacy mental health mobile apps. mHealth. 2018;4–7.
Mani M, Psychology A, Kavanagh DJ, Hides L. Review and Evaluation of Mindfulness-Based iPhone Apps Corresponding Author : JMIR mHealth uHealth. 2015;3:1–10.
Harrer M, Adam SH, Fleischmann RJ, Baumeister H, Auerbach R, Bruffaerts R, et al. Effectiveness of an internet- and app-based intervention for college students with elevated stress: Randomized controlled trial. J Med Internet Res. 2018;20(4):1–16.
Ponzo S, Morelli D, Kawadler JM, Hemmings NR, Bird G, Plans D. Efficacy of the digital therapeutic mobile app biobase to reduce stress and improve mental well-being among university students: Randomized controlled trial. JMIR mHealth uHealth. 2020;8(4).
Lee RA, Jung ME, Jung ME. Evaluation of an mHealth App ( DeStressify ) on University Students ’ Mental Health : Pilot Trial Corresponding Author : JMIR mHealth uHealth. 2018;5.
Stawarz K, Preist C, Coyle D. Use of smartphone apps, social media, and web-based resources to support mental health and well-being: Online survey. JMIR Ment Heal. 2019;6(7):1–14.
McCloud T, Jones R, Lewis G, Bell V, Tsakanikos E. Effectiveness of a mobile app intervention for anxiety and depression symptoms in university students: Randomized controlled trial. JMIR mHealth uHealth. 2020;8(7):1–15.
Peng C, He M, Cutrona SL, Kiefe CI, Liu F, Wang Z. Theme trends and knowledge structure on mobile health apps: Bibliometric analysis. JMIR mHealth uHealth. 2020;8(7).
Chen I, Pakpour AH, Leung H, Potenza MN, Su J, Lin C, et al. Comparing generalized and specific problematic smartphone/internet use: Longitudinal relationships between smartphone application-based addiction and social media addiction and psychological distress. J Behav Addict [Internet]. 2020 Jun;9(2):410–9. Available from: https://akjournals.com/view/journals/2006/9/2/article-p410.xml
Graham AK, Greene CJ, Kwasny MJ, Kaiser SM, Lieponis P, Powell T, et al. Coached mobile app platform for the treatment of depression and anxiety among primary care patients: A randomized clinical trial. JAMA Psychiatry. 2020;77(9):906–14.
Montagni I, Cariou T, Feuillet T, Langlois E, Tzourio C. Exploring digital health use and opinions of university students: Field survey study. JMIR mHealth uHealth. 2018;6(3):1–13.
Levin ME, Hicks ET, Krafft J. Pilot evaluation of the stop , breathe & think mindfulness app for student clients on a college counseling center waitlist on a college counseling center waitlist. J Am Coll Heal. 2020;0(0):1–9.
Connolly SL, Kuhn E, Possemato K, Torous J. Digital Clinics and Mobile Technology Implementation for Mental Health Care. Curr Psychiatry Rep [Internet]. 2021 Jul 7;23(7):38. Available from: https://link.springer.com/10.1007/s11920-021-01254-8
Galatzer-Levy IR, Onnela JP. Machine Learning and the Digital Measurement of Psychological Health. Annu Rev Clin Psychol. 2023;19:133–54.
Prasad N, Chien I, Regan T, Enrique A, Palacios J, Keegan D, et al. Deep learning for the prediction of clinical outcomes in internet-delivered CBT for depression and anxiety. Cowley H, editor. PLoS One [Internet]. 2023 Nov 27;18(11):e0272685. Available from: https://dx.plos.org/10.1371/journal.pone.0272685
Alsubaie MM, Stain HJ, Webster LAD, Wadman R. The role of sources of social support on depression and quality of life for university students. Int J Adolesc Youth [Internet]. 2019 Oct 2;24(4):484–96. Available from: https://www.tandfonline.com/doi/full/10.1080/02673843.2019.1568887
Felder JN, Epel ES, Neuhaus J, Krystal AD, Prather AA. Randomized controlled trial of digital cognitive behavior therapy for prenatal insomnia symptoms: Effects on postpartum insomnia and mental health. Sleep. 2022;45(2):1–9.
Wibawanti R, Agustina A, Werdhani RA. Development of FRAMES (Fatigue Risk Assessment with Medical Advise) Application: Self-Assessment Application for Pilots. Indones J Community Occup Med. 2023;2(3):132–5.
Huberty J, Sullivan M, Green J, Kurka J, Leiferman J, Gold K, et al. Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial. BMC Complement Med Ther. 2020;20(1):173.
McKenna F, Gibbons M, Imcha M, Duffy RM, Mohamad MM. Anxiety in a Specialist Perinatal Mental Health Service: patient characteristics, management, and outcomes. Ir J Psychol Med. 2023;40(4):561–5.
Christiansen J, Qualter P, Friis K, Pedersen SS, Lund R, Andersen CM, et al. Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Public Health. 2021 Jul;141(4):226–36.
Jones MS, Womack V, Jérémie-Brink G, Dickens DD. Gendered Racism and Mental Health among Young Adult U.S. Black Women: The Moderating Roles of Gendered Racial Identity Centrality and Identity Shifting. Sex Roles [Internet]. 2021 Aug 12;85(3–4):221–31. Available from: https://link.springer.com/10.1007/s11199-020-01214-1
Walsh NA, Repa LM, Garland SN. Mindful larks and lonely owls: The relationship between chronotype, mental health, sleep quality, and social support in young adults. J Sleep Res. 2022 Feb;31(1).
Y?ld?r?m M, Çelik Tanr?verdi F. Social Support, Resilience and Subjective Well-being in College Students. J Posit Sch Psychol. 2020 Sep;5(2):127–35.
Zhao H, You J, Peng Y, Feng Y. Machine Learning Algorithm Using Electronic Chart-Derived Data to Predict Delirium After Elderly Hip Fracture Surgeries: A Retrospective Case-Control Study. Front Surg [Internet]. 2021 Jul 13;8(July):1–9. Available from: https://www.frontiersin.org/articles/10.3389/fsurg.2021.634629/full
Nejad FK, Shahraki KA, Nejad PS, Moghaddam NK, Jahani Y, Divsalar P. The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: A randomized clinical trial. J Prev Med Hyg. 2021;62(1):E82–8.
Choi E-H, Chun MY, Lee I, Yoo Y-G, Kim M-J. The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents. Int J Environ Res Public Health [Internet]. 2020 May 7;17(9):3263. Available from: https://www.mdpi.com/1660-4601/17/9/3263
Caponnetto P, Casu M. Update on Cyber Health Psychology: Virtual Reality and Mobile Health Tools in Psychotherapy, Clinical Rehabilitation, and Addiction Treatment. Int J Environ Res Public Health. 2022;19(6).
Yubero S, de las Heras M, Navarro R, Larrañaga E. Relations among chronic bullying victimization, subjective well-being and resilience in university students: a preliminary study. Curr Psychol. 2023 Jan;42(2):855–66.
Sabouripour F, Roslan S, Ghiami Z, Memon MA. Mediating Role of Self-Efficacy in the Relationship Between Optimism, Psychological Well-Being, and Resilience Among Iranian Students. Front Psychol. 2021 Jun;12.
Matteucci MC, Soncini A. Self-efficacy and psychological well-being in a sample of Italian university students with and without Specific Learning Disorder. Res Dev Disabil. 2021 Mar;110:103858.
Singh V, Kumar A, Gupta S. Mental Health Prevention and Promotion—A Narrative Review. Front Psychiatry [Internet]. 2022 Jul 26;13. Available from: https://www.frontiersin.org/articles/10.3389/fpsyt.2022.898009/full
Naslund JA, Aschbrenner KA, Kim SJ, McHugo GJ, Unützer J, Bartels SJ, et al. Health behavior models for informing digital technology interventions for individuals with mental illness. Psychiatr Rehabil J [Internet]. 2017 Sep;40(3):325–35. Available from: https://doi.apa.org/doi/10.1037/prj0000246
Ellis LA, Meulenbroeks I, Churruca K, Pomare C, Hatem S, Harrison R, et al. The Application of e-Mental Health in Response to COVID-19: Scoping Review and Bibliometric Analysis. JMIR Ment Heal [Internet]. 2021 Dec 6;8(12):e32948. Available from: https://mental.jmir.org/2021/12/e32948
Armaou M, Pears M, Konstantinidis ST, Blake H. Evolution of Primary Research Studies in Digital Interventions for Mental Well-Being Promotion from 2004 to 2023: A Bibliometric Analysis of Studies on the Web of Science. Int J Environ Res Public Health [Internet]. 2024 Mar 21;21(3):375. Available from: https://www.mdpi.com/1660-4601/21/3/375
Levin ME, Hicks ET, Krafft J. Pilot evaluation of the stop, breathe & think mindfulness app for student clients on a college counseling center waitlist. J Am Coll Heal [Internet]. 2022;70(1):165–73. Available from: https://doi.org/10.1080/07448481.2020.1728281
Copyright (c) 2025 Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Media Publikasi Promosi Kesehatan Indonesia retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Media Publikasi Promosi Kesehatan Indonesia.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.
