Adolescents and young adults (AYA) often face mental health challenges and are heavily influenced by technology. Digital health interventions (DHIs), leveraging smartphone data and artificial intelligence, offer immense potential for personalized and accessible mental health support. However, ethical guidelines for DHI research fail to address AYA’s unique developmental and technological needs and leave crucial ethical questions unanswered. This gap creates risks of either over- or under-protecting AYA in DHI research, slowing progress and causing harm. This Perspective examines ethical gaps in DHI research for AYA, focusing on three critical domains: challenges of passive data collection and artificial intelligence, consent practices, and risks of exacerbating inequities. We propose an agenda for ethical guidance based on bioethical principles autonomy, respect for persons, beneficence and justice, developed through participatory research with AYA, particularly marginalized groups. We discuss methodologies to achieve this agenda, ensuring ethical, youth-focused and equitable DHI research for the mental health of AYA.

Introduction After COVID-19, a global mental health crisis affects young people, with one in five youth experiencing mental health problems worldwide. Delivering mental health interventions via mobile devices is a promising strategy to address the treatment gap. Mental health apps are effective for adolescent and young adult samples, but face challenges such as low real-world reach and under-representation of minoritised youth. To increase digital health uptake, including among minoritised youth, there is a need for diversity, equity and inclusion (DEI) considerations in the development and evaluation of mental health apps. How well DEI is integrated into youth mental health apps has not been comprehensively assessed. This scoping review aims to examine to what extent DEI considerations are integrated into the design and evaluation of youth mental health apps and report on youth, caregiver and other stakeholder involvement. Methods and analysis We will identify studies published in English from 2009 to 29 September 2023 on apps for mental health in youth. We will use PubMed, Global Health, APA PsycINFO, SCOPUS, CINAHL PLUS and the Cochrane Database and will report according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension guidelines. Papers eligible for inclusion must be peer-reviewed publications in English involving smartphone applications used by adolescents or young adults aged 10–25, with a focus on depression, anxiety or suicidal ideation. Two independent reviewers will review and extract articles using a template developed by the authors. We will analyse the data using narrative synthesis and descriptive statistics. This study will identify gaps in the literature and provide a roadmap for equitable and inclusive mental health apps for youth. Ethics and dissemination Ethics approval is not required. Findings will be disseminated through academic, industry, community networks and scientific publications.