A B S T R A C T
As the capital of Iran and a hub for the emergence and application of new technologies, Tehran is deeply influenced by ongoing social and technological transformations. Its citizens are increasingly exposed to both the opportunities and risks associated with digitalization and the rapid growth of related technologies. Accordingly, this study seeks to identify and examine the key drivers shaping the future of citizens’ health, explore possible scenarios and transformations in mental health under the influence of digital technologies, and propose strategic courses of action. This applied research employed multiple data collection techniques, including desk research, expert interviews (n=54), Delphi surveys (n=36), and consensus-building workshops (n=15). Analytical methods comprised environmental scanning, structural analysis, scenario development, and hierarchical analysis. Experts were identified through purposive sampling. Findings reveal four potential scenarios for the future of mental health in Tehran in relation to digital risks and therapeutic opportunities. Experts considered the second and third scenarios to be the most plausible. The first scenario, representing an ideal state, was identified as the most desirable outcome, toward which urban policymakers must intensify their efforts. Conversely, the fourth scenario represents the least desirable trajectory, which policymakers should proactively seek to prevent. Consequently, measures such as enhancing investment in digital mental health technologies, strengthening public–private support for innovation, expanding digital treatment options and integrating them with conventional care, enacting robust data privacy and security regulations, bridging the intergenerational digital divide through media literacy initiatives, and fostering greater stakeholder participation in service development can collectively improve the mental health of Tehran’s citizens in the face of digital risks and opportunities.
Extended Abstract
Introduction
The digitalization of human life—particularly in urban contexts—presents both significant risks and promising opportunities for addressing mental health challenges. In the coming decades, emerging technologies are expected to fundamentally transform the ways in which people live, work, and interact with their environments. While such innovations hold the potential to enhance efficiency, convenience, and communication, inadequate management may lead to unintended consequences for the mental well-being of urban populations.
As the capital of Iran and a key locus for the emergence and application of new technologies, Tehran is highly affected by socio-technological transformations. Its citizens are therefore exposed to both the opportunities and challenges associated with digitalization and the rapid expansion of related technologies. Accordingly, this study aims to identify and analyze the drivers shaping the future of citizens’ health, with a particular focus on scenario-building and potential transformations in mental health under the influence of digital technologies. This applied study adopts a mixed-methods approach, drawing on data collected through interviews, expert consensus, and Delphi surveys.
 
Methodology
This applied study employed a mixed-methods approach, combining quantitative and qualitative techniques, with data collected through library research, expert interviews, consensus workshops, and structured questionnaires. Aligned with the study objectives, the STEEP framework was initially applied to identify key drivers influencing the future of urban mental health. This approach assumes that the urban environment emerges from a complex interplay of forces and dynamic processes. Among various frameworks, the STEEP model is the most widely used, classifying factors into five domains: economic, social, technological, environmental, and political.
Subsequently, structural-interpretive analysis (using MICMAC software in combination with expert consensus) was conducted to identify and examine the key influential drivers. A structured questionnaire was then designed, and the importance and uncertainty of each driver were assessed through the Delphi method. Recognizing that a driver’s uncertainty alone does not determine its relevance for scenario development—both high importance and significant uncertainty are required—critical uncertainties were subsequently identified.
To determine the overall importance of each driver, results from the Delphi survey were combined with cross-impact analysis. Specifically, the average importance score derived from the Delphi survey was multiplied by each driver’s total impact on all other drivers, yielding a final weighted importance score. The impact calculation was based on the mean of direct and indirect influence matrices. Both importance and uncertainty values were then normalized and plotted in a critical uncertainty diagram.
Considering these critical uncertainties, experts completed an uncertainty questionnaire using Scenario Wizard software, which facilitated the development and articulation of future scenarios. Finally, strategies tailored to the most plausible scenarios were identified and prioritized through hierarchical analysis.
 
Results and discussion
The findings indicate that while most drivers exhibit some level of uncertainty, several critical uncertainties were identified: government support for digital mental health innovations, the intergenerational digital divide, cybersecurity risks in digital mental health platforms, the emergence and effectiveness of digital therapies, and the extent of stakeholder engagement in the development of digital mental health services.
Additionally, four scenarios were developed to explore the future of mental health in Tehran in the context of digital risks and therapeutic opportunities. Among these, the second and third scenarios were assessed as the most plausible. The first scenario represents the most favorable, ideal state, encompassing all desired features. In this scenario, government support for digital mental health innovations remains consistently high, the intergenerational digital divide is effectively managed, cybersecurity risks are minimized, digital therapies are successfully implemented, and stakeholder engagement in service development reaches its maximum level.
Although the first scenario is the most desirable, it is unlikely to materialize in the short term; the second and third scenarios appear more probable given the current national context. Nevertheless, urban policymakers must continue to take proactive measures across multiple dimensions to advance toward the ideal scenario. The fourth scenario represents the least desirable trajectory, which must be actively prevented, as it could quickly emerge if urban policymakers remain passive.
 
Conclusion
Consequently, implementing measures such as increasing investment in digital mental health technologies, strengthening public and private support for innovation, expanding digital treatment options and integrating them with conventional care, establishing robust legal frameworks to safeguard user privacy and data security, bridging the intergenerational digital divide through media literacy initiatives, and enhancing stakeholder participation in the development of digital mental health services can collectively improve the mental health of Tehran’s citizens in the face of digital risks and opportunities.
 
Funding
There is no funding support.
 
Authors’ Contribution
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved thecontent of the manuscript and agreed on all aspects of the work declaration of competing interest none.
 
Conflict of Interest
Authors declared no conflict of interest.
 
 
Acknowledgments
We are grateful to all the scientific consultants of this paper.