Evaluating predictive artificial intelligence approaches used in mobile health platforms to forecast mental health symptoms among youth: a systematic review

•Multimodal approaches via wearables and smartphones enhance prediction.•Successful predictors are smartphone usage, sleep patterns, and physical activity.•Current challenges are small sample sizes, data privacy issues, & incomplete data.•Key prediction algorithms include Logistic Regression and Support Vector Machines.•Current predictive models lack human-centred artificial intelligence. The youth mental health crisis is exacerbated by limited access to care and resources. Mobile health (mHealth) platforms using predictive artificial intelligence (AI) can improve access and reduce barriers, enabling real-time responses and precision prevention. This systematic review evaluates predictive AI approaches in mHealth platforms for forecasting mental health symptoms among youth (13–25 years). We searched studies from Embase, PubMed, Web of Science, PsycInfo, and CENTRAL, to identify relevant studies. From 11 studies identified, three studies predicted multiple symptoms, with depression being the most common (63%). Most platforms used smartphones and 25% integrated wearables. Key predictors included smartphone usage (N=5), sleep metrics (N=6), and physical activity (N=5). Nuanced predictors like usage locations and sleep stages improved prediction. Logistic regression was most used (N=6), followed by Support Vector Machines (N=3) and ensemble methods (N=4). F-scores for anxiety and depression ranged from 0.73 to 0.84, and AUCs from 0.50 to 0.74. Stress models had AUCs of 0.68 to 0.83. Bayesian model selection and Shapley values enhanced robustness and interpretability. Barriers included small sample sizes, privacy concerns, missing data, and underrepresentation bias. Rigorous evaluation of predictive performance, generalizability, and user engagement is critical before mHealth platforms are integrated into psychiatric care. [Display omitted]