  The field of digital mental health is advancing at a rapid pace. Passively
collected data from user engagements with digital tools and services continue
to contribute new insights into mental health and illness. As the field of
digital mental health grows, a concerning norm has been established -- digital
service users are given little say over how their data is collected, shared, or
used to generate revenue for private companies. Given a long history of service
user exclusion from data collection practices, we propose an alternative
approach that is attentive to this history: the consent-forward paradigm. This
paradigm embeds principles of affirmative consent in the design of digital
mental health tools and services, strengthening trust through designing around
individual choices and needs, and proactively protecting users from unexpected
harm. In this perspective, we outline practical steps to implement this
paradigm, toward ensuring that people searching for care have the safest
experiences possible.
