The authors evaluate a Los Angeles County Department of Mental Health initiative to provide residents with free access to iPrevail, an app with mental health education and resources. The authors report on awareness of iPrevail, general trends of app users who engaged in structured app activities, whether user characteristics were associated with app engagement, and whether engagement in app activities was associated with symptom change.

Evaluation of iPrevail Los Angeles County

An Initiative to Provide a Free Mental Health App to Los Angeles County Residents

Graham DiGuiseppi, Elizabeth Roth, Rebecca L. Collins, Nicole K. Eberhart

ResearchPublished Dec 20, 2024

In June 2021, the Los Angeles County Department of Mental Health (LACDMH) partnered with Prevail Health to make the iPrevail mental health app freely available to all county residents. iPrevail provides users with around-the-clock access to education and support resources for a variety of mental health conditions.

In this report, the authors present an analysis of administrative data collected from iPrevail users in Los Angeles County from March 1, 2023, through June 30, 2024, with a focus on users who followed structured activities in the app that included self-assessments, chats with a trained peer coach, online communities, and structured educational activities based on users' self-identified most important mental health topic areas.

The authors report on the general trends of iPrevail use. They also examine whether user characteristics were associated with app engagement and whether engagement in specific app activities was associated with symptom change over time. Finally, they use results of a recently completed representative survey to investigate county residents' awareness of iPrevail.

Survey findings indicate that 5 percent of county youth ages 14–25 and 2 percent of county adults ages 26 and older were aware of iPrevail in summer 2024. App use data showed that the number of new users who followed structured activities declined throughout the reporting period, and 75 percent of users were active in the app for only one day. Seventy-seven percent of users had moderate or severe mental health symptoms, and there was no evidence of symptom change over time.

Key Findings

  • Five percent of Los Angeles County youth ages 14–25 and 2 percent of adults ages 26 and older have heard of iPrevail and correctly identified it as a mental health app.
  • From March 2023 through June 2024, there were 9,066 new users who followed structured app activities and 56,125 users who only chatted with a peer coach.
  • The number of new users peaked in March 2023 and then declined throughout 2023–2024.
  • Compared with data from 2021 to 2022, there was a greater proportion of Hispanic/Latino/Latina and Black users, users who primarily spoke Spanish or another non-English language at home, users with a disability, and veterans.
  • There was no evidence of an increase in Chinese-language users following the release of a Chinese version of iPrevail in January 2024.
  • Most users (75 percent) were active in the app for only one day, and 96 percent of users completed at least one meaningful activity. The most popular activities were demographic and health assessments and chats with a peer coach.
  • Most users (77 percent) had moderate or severe mental health symptoms on health assessments at baseline, suggesting that the app was being used by residents in high need of mental health services.
  • There was no evidence of symptom change for those who used the app for a longer period. Low rates of follow-up assessment completion precluded determination of whether app use was associated with a reduction in mental health symptoms.

Recommendations

  • Given the limited number of users who used iPrevail for more than one day, further usability testing should be conducted to understand how to improve app engagement. Ideally, this should involve qualitative user engagement analysis and co-design with specific user groups to determine whether further improvements to the app are needed.
  • To increase awareness of iPrevail and enrollment of new users, LACDMH may consider expanding marketing after app engagement is improved. LACDMH should consider promoting iPrevail in their ongoing mental health campaigns, such as Take Action for Mental Health.
  • If additional usability testing to promote engagement is not possible, LACDMH should consider investing in another mental health app that is more engaging to users.
  • Future evaluations should prioritize collection of more-robust follow-up data. It is possible that use of iPrevail was associated with symptom improvements, but this could not be determined, given the lack of follow-up assessment data available.

Topics

Document Details

  • Copyright: California Mental Health Services Authority
  • Publisher: RAND Corporation
  • Availability: Web-Only
  • Year: 2024
  • Pages: 24
  • DOI: https://doi.org/10.7249/RRA3569-1
  • Document Number: RR-A3569-1

Citation

RAND Style Manual

DiGuiseppi, Graham, Elizabeth Roth, Rebecca L. Collins, and Nicole K. Eberhart, Evaluation of iPrevail Los Angeles County: An Initiative to Provide a Free Mental Health App to Los Angeles County Residents, RAND Corporation, RR-A3569-1, 2024. As of April 30, 2025: https://www.rand.org/pubs/research_reports/RRA3569-1.html

Chicago Manual of Style

DiGuiseppi, Graham, Elizabeth Roth, Rebecca L. Collins, and Nicole K. Eberhart, Evaluation of iPrevail Los Angeles County: An Initiative to Provide a Free Mental Health App to Los Angeles County Residents. Santa Monica, CA: RAND Corporation, 2024. https://www.rand.org/pubs/research_reports/RRA3569-1.html.
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This research was funded by the Los Angeles County Department of Mental Health (LACDMH), via the California Mental Health Services Authority (CalMHSA) and carried out within the Access and Delivery Program in RAND Health Care.

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