Quality and Privacy Policy Compliance of Mental Health Care Apps in China: Cross-Sectional Evaluation Study

J Med Internet Res. 2025 Jul 3:27:e66762. doi: 10.2196/66762.

Abstract

Background: The global prevalence of mental health issues such as depression and anxiety is escalating, yet access to high-quality care remains severely limited. Although mental health care apps can enhance outcomes, their handling of highly sensitive personal data poses significant privacy risks.

Objective: This study systematically investigated Chinese mental health care apps, assessing their quality and privacy policy compliance through an integrated framework of the Information Security Technology-Personal Information Security Specification (GB/t 35273-2020) and the Mobile App Rating Scale (MARS).

Methods: A comprehensive search on the Chinese iOS and Android platforms identified apps for evaluation by 2 independent reviewers. Each app was assessed for general characteristics, professional context, functionality, quality, and privacy policy compliance using a previously published privacy policy compliance scale and the MARS.

Results: A comprehensive analysis of the 115 identified apps revealed that all provided privacy policy links on their marketplace interfaces. Of these 115 apps, 104 (90.4%) displayed policy reminders during log-in, but only 85 (73.9%) implemented policy pop-ups or required active user confirmation. The average privacy policy compliance score across the 115 apps was 60.83% (SD 21.75%), with the highest average compliance in general characteristics (80.58%, SD 19.01%) and the lowest in information destruction (49.57%, SD 28.67%). Only 2 (1.7%) of the 115 apps notified third parties to promptly delete personal information. The mean MARS score was 3.41 (SD 0.26), indicating generally good app quality. A significantly positive correlation was found between MARS total scores and overall privacy policy compliance (r=0.354; P<.01), with the strongest associations observed for information destruction (r=0.405; P<.01) and data sharing or transfer (r=0.324; P<.01).

Conclusions: Although privacy policy compliance in Chinese mental health care apps is at a moderate level, superficial personal information protections, inadequate implementation, and poor transparency in information destruction persist. The findings indicate that enhancing privacy policy compliance can significantly improve app quality and user engagement. Therefore, China's internet content regulators should establish robust enforcement and oversight systems to strengthen the supervision of mental health care apps, elevating their privacy policy compliance to ensure the sustainable development of high-quality apps with enhanced privacy protection standards.

Keywords: content analysis; mental health; mental health care; mobile apps; privacy policy.

MeSH terms

  • China
  • Computer Security
  • Confidentiality*
  • Cross-Sectional Studies
  • Humans
  • Mental Health Services*
  • Mobile Applications* / standards
  • Privacy*