Local Language Adaptations of Mental Health Self-Help Apps: A Usability Study

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Dr. Tushar Mehrotra
DCSE, Galgotias University , Greater Noida, UP, India
tushar.mehrotra@galgotiasuniversity.edu.in

Abstract

Digital self-help applications for mental health are proliferating, yet many are designed primarily in English and exported with minimal adaptation to users’ linguistic and cultural contexts. This study evaluates whether local language adaptations—beyond direct translation—improve usability, comprehension, and perceived trust in mental health self-help apps among adult smartphone users in India. We conducted a mixed-methods, within-subjects usability study (N = 208; speakers of Hindi, Bengali, Marathi, and Tamil) using a counterbalanced design to compare an English baseline app with a linguistically and culturally adapted version. The adapted version incorporated plain-language microcopy, dialect-aware wording, culturally resonant examples and metaphors for mood skills, script-specific typography, text-to-speech for low-literacy support, and localization of crisis resources and privacy statements. Quantitative outcomes included System Usability Scale (SUS), task success, time-on-task, error rates, and comprehension checks for consent and safety content. Qualitative outcomes were drawn from think-aloud and semi-structured interviews analyzed thematically. The adapted app increased SUS by 12.4 points on average (95% CI: 10.7–14.1), reduced median time-on-task by 22%, and improved correct comprehension of privacy statements by 27 percentage points (all p < .001). Gains were largest for participants reporting lower English proficiency and for tasks involving sensitive disclosures (mood logging, safety planning). Participants described the adapted wording as “clearer,” “less clinical,” and “more humane,” and reported higher willingness to continue use and to recommend the app to family members.

Keywords

Mental Health Apps, Localization, Usability, System Usability Scale, Cultural Adaptation, Digital Health, India, Plain Language

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