Expected Competencies and Personal Attributes of Digital Navigators to Support Digital Mental Health Care: A Focus Group and Interview Study With Patients and Health Care Professionals (Preprint)

Abstract

BACKGROUND Digital mental health apps (DMHA) and in particular digital therapeutics (DTx) offer promising opportunities to support mental health care. However, their effective use in outpatient settings in Germany remains limited. To overcome this gap, the role of Digital Navigators (DNs) has been introduced – individuals who support patients and health care professionals in selecting, using, and integrating DMHA into care. Despite increasing interest in this role, there is limited evidence on the competencies, knowledge, and personal attributes required for DNs to work effectively in mental health settings. OBJECTIVE The study explores the expected competencies, knowledge areas, and personal attributes that DNs need to effectively support the implementation and use of DTx in outpatient mental health care. METHODS As part of the pre-study of the DigiNavi study, a qualitative study was conducted involving n=35 participants (n=7 general practitioners (GPs), n=8 general practice patients, n=11 outpatient psychiatrists/psychologists, n=9 psychiatric patients) from different general practices and psychiatric outpatient clinics in Germany. 17 semi-structured interviews and 4 focus groups were conducted to explore expectations of DNs. Data were analyzed using qualitative content analysis. RESULTS Participants emphasized that DNs should combine strong interpersonal skills (empathy, patience, sensitive communication) with technical and basic clinical competencies. Most favored DNs as integrated clinical team members (e.g., medical assistants), citing their existing patient relationships, but noted time and training constraints. Key expectations included the ability to support patients with DTx use, adapt communication to individual needs, and convey data privacy information clearly. Foundational knowledge of mental health conditions and sensitivity to crises were considered important for identifying warning signs and escalating concerns. While DNs were seen as essential intermediaries between patients, healthcare professionals, and DTx, participants highlighted the necessity for clearly defined roles, structured training, and realistic expectations to prevent role overload and enable sustainable implementation in outpatient mental health care. CONCLUSIONS DNs require a special skillset that bridges clinical understanding, digital expertise, and interpersonal competence. Our results lay the groundwork for developing training curricula and implementation strategies that align with real-world expectations for the DN role. Defining these core competencies is essential for supporting the sustainable and effective integration of DMHA into mental health care. CLINICALTRIAL German Clinical Trial Register: DRKS00034327, https://drks.de/search/en/trial/DRKS00034327; ClinicalTrials.gov: NCT06575582, https://clinicaltrials.gov/study/NCT06575582 INTERNATIONAL REGISTERED REPORT RR2-10.2196/67655

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