Before building mental health apps, designers need to understand the problem
· Medical Xpressby Kevin Manne, University at Buffalo
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When technology designers work on mental health issues that people tend to conceal or struggle to describe, they often end up with elegant solutions that can make problems worse, according to new research from the University at Buffalo School of Management.
The study, published in the journal Decision Support Systems, explores "wicked psychosocial problems"—the painful mental disorders people hide—to uncover how scientists can get to the root of problems like social anxiety and loneliness before developing technical solutions.
"Stigma, shame and fear of being judged keep the real problems out of view," says study co-author Joana Gaia, Ph.D., clinical assistant professor of management science and systems in the UB School of Management.
"People tend to minimize what they are going through, disclose only fragments or reframe their situation in more acceptable terms. Designers then build tools like digital therapy services and self-guided mental health apps around a picture of the problem that was never accurate to begin with."
The researchers compared two independent design science projects to examine how each team defined the problem. The first used topic modeling and hand-coding to analyze more than 6,000 anonymous forum posts that explored social anxiety disorder among adults. The second used staff interviews, call observations and workshops to study loneliness among older adults who called a service center repeatedly without ever saying they were lonely.
Their findings revealed that the people with social anxiety weren't getting help because they were worried about being judged, not because help was hard to find. And for the older adults who were lonely, the problem was that although workers could tell the callers were lonely, there was no official way for them to say so or do anything about it.
From these two projects, the researchers uncovered seven rules for anyone designing services or technology around a sensitive problem:
- Stay flexible about how you investigate rather than locking in one method at the start.
- Slow down when early findings feel thin and build that pause into the schedule.
- Move back and forth between individual stories and the bigger patterns instead of picking one.
- When accounts contradict each other, treat that as information rather than a mess to clean up.
- Bring the people closest to the problem in as partners who help interpret what's going on, not just as sources to collect from.
- Hold off on committing to a solution while the picture is still forming.
- And when a finding feels especially satisfying or convenient, check it against other evidence before acting on it.
"When people have good reasons to keep something hidden, the real work is in understanding the problem," says study co-author Raj Sharman, professor of management science and systems in the UB School of Management. "A well-built solution aimed at the wrong problem is a waste of effort that can leave people feeling more exposed than before."
More information
Pavankumar Mulgund et al, Problem space exploration for wicked psychosocial problems: Insights from two cases, Decision Support Systems (2026). DOI: 10.1016/j.dss.2026.114697
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