"I Don't Want My Mental Health App To Give Me Mental Health Barriers": Unpacking The Need For Digital Mental Health Tracking Services With And For The Blind Community

2026-08-11

AI Summary

This study addresses the systemic exclusion of blind individuals from current digital mental health services, which predominantly center on sighted users. Employing an explanatory sequential mixed-methods design, the research integrates survey data from 93 legally blind participants with semi-structured interviews from 10 individuals, analyzed through descriptive statistics, Kruskal-Wallis tests, and inductive thematic analysis. Findings reveal active engagement with core functionalities—such as mindfulness and sleep tracking—alongside a pervasive absence of community support features. Grounded in the eHealth literacy framework, the study proposes three innovative design principles: transparent pre-deployment accessibility evaluations, natively accessible interfaces, and user-controlled data sovereignty. It advocates a paradigm shift from retrofitting accessibility toward inclusive co-design with blind users from the outset.

Abstract

Digital mental health (DMH) tracking services promise continuous, personalized support for well-being, but their design often assumes sighted users. For the blind community, this assumption produces a distinct pattern of exclusion: services whose accessibility cannot be evaluated without first paying for them, community features that exclude the users they purport to support, and interfaces that leave users digitally literate but functionally blocked. We report on an explanatory sequential mixed-methods study of blind users' experiences with DMH tracking services in the United States. In the first phase, 93 legally blind adults completed a survey about their usage patterns, adoption decisions, and data-agency preferences; in the second, 10 survey respondents participated in semi-structured interviews. We analyzed closed-ended responses using descriptive statistics and the Kruskal-Wallis test, and open-ended and interview data using inductive thematic analysis, interpreting findings through Norman and Skinner's eHealth Literacy framework. Participants identified mindfulness, sleep, and goal-tracking services as their most-used categories, but also described recurring exclusion from the community-support features that other users value most. We argue that the framework's "computer literacy" dimension is insufficient on its own: many of our participants possessed the literacy but were blocked from applying it by design choices that predate the user. We contribute design recommendations for transparent pre-purchase accessibility evaluation, accessibility-native rather than retrofitted interfaces, and user-controlled data agency -- recommendations intended not to accommodate blind users but to design DMH tracking services with them from the start.

Problem

• digital mental health
• accessibility
• blind community
• exclusion
• user-centered design

Innovation

• accessible design
• digital mental health
• co-design
• eHealth literacy
• mixed-methods study