Imaginaries of digital health: Unpacking the platformization of mental health through users' practices.

Users value flexibility and accessibility provided by digital mental health infrastructures while simultaneously encountering infrastructural misalignments.

• Infrastructural misalignments included unstable connections and opaque algorithmic matching processes
• The study used a mixed-methods design combining qualitative interviews (N=12) with a quantitative survey (N=3870)
• The platform examined was Unobravo, an Italian digital platform offering online psychotherapy
• Users' narratives and patterns of engagement were analyzed to identify these tensions

Users engage in practices of domestication to address challenges posed by digital mental health platforms.

• Domestication practices reconfigure the therapeutic setting by integrating care into mobile and domestic environments
• These practices involve adapting digital infrastructures to fit everyday life contexts
• The therapeutic setting is reframed as a datafied and everyday space through these practices
• Domestication serves as a user-level strategy to negotiate infrastructural misalignments

Platform imaginaries of efficiency, accessibility, and personalization are both enacted and contested in users' everyday practices.

• The study drew on Science and Technology Studies and digital health literature to theorize platform imaginaries
• A persistent tension was found between the promise of algorithmic efficiency and the realities of situated practice
• Qualitative interviews (N=12) were used to explore users' narratives about these imaginaries
• Algorithmic matching processes were described by users as opaque, complicating the imaginary of personalization

The platformization of mental health reshapes the organization of mental health services, redefining access, relationships, and meanings of care.

• Platformization is examined through the specific case of Unobravo in the Italian context
• The study situates this transformation within broader trends in the platformization of healthcare
• The research combined a survey of N=3870 users with N=12 qualitative interviews to capture both breadth and depth
• The therapeutic setting is reconfigured as a datafied space through platform-mediated care

A mixed-methods design combining qualitative interviews and a large-scale quantitative survey was used to analyze user experiences of a digital mental health platform.

• Qualitative interviews: N=12
• Quantitative survey: N=3870
• The study analyzed both users' narratives (qualitative) and patterns of engagement (quantitative)
• The platform studied was Unobravo, an Italian digital psychotherapy service