It’s been more than a year now since the pandemic has taken over and severely impacted our lives in many different ways. Although we’ve been living this ’new normal‘ for quite some time now, I still haven’t been able to adapt to this situation completely, and it seems that I’m not the only one. Many people suffer from the social distancing measures like isolation, homeschooling and home office and are trying out mental health apps to help them during these difficult times. But can such apps truly improve your mental well-being? Is it possible for an app to replace a professional? I’ve learned that there are severe issues regarding such apps, and many of these apps don’t deliver what they promise. Hence, I want to raise awareness of these risks and give you some criteria and means to assess and find a reliable, well-designed mental health app.
COVID-19 and the rise of mental health apps
Mobile phones have evolved from devices used to make calls to agendas, cameras, mp3 players to platforms for online dating, trading of stocks, etc. Consequently, it was only a matter of time when we would start using our mobile phones also to improve
our mental health.
Today there are over 10’000 mental health apps and the current situation with COVID-19 might have even accelerated this trend of using such apps. Numbers show that Covid-19 has spiked the download of mental health apps ranging from meditation and wellness apps like Headspace to teletherapy platforms like Talkspace. At the same time, mental health studies were on top of the list of publications in 2020. They show us that the pandemic also has positive effects, such as that the taboo around the topic of mental health is slowly being lifted. As a result of more conversation around this topic, more people have become aware of mental health’s importance. This might be another factor that contributed to the rise of downloads during the pandemic.
Furthermore, many mental health apps were heavily advertised during the pandemic. Some like Calm are even offering free memberships now to attract and gain new users. As a result, the app reached more than 911’000 downloads in April 2020, which means an increase of almost 31% compared to January 2020 (Perez, 2020).
Mental health apps currently make use and benefit from the situational need of people. They are booming as they can offer instant access to help from literally anywhere where there is internet service without having to adhere to any restrictions imposed because of COVID-19.
How mental health apps have opened access to aid
Mental health apps have given people who live in rural areas the opportunity to access help, which might previously not have had the chance to it. Furthermore, they offer the comfort of not having to leave your or home or even bed to get help. This consequently also affects that compared to visiting a mental health professional, such apps can offer more anonymity, which means that there is one less barrier to seeking help. Mental health apps have also allowed people from lower socioeconomic backgrounds to access affordable treatment, which might not have been possible due to the costs of a private face-to-face session. For example, a monthly membership on Talkspace where you have unlimited therapy (text, video, and audio messaging, therapist replies daily, five times a week) costs only 260$ a month. In contrast, for one fifty-minute therapy session in Switzerland, costs range from 140 – 170 CHF (Psychotherapy in Switzerland, 2021).
By being available everywhere at a comparatively low cost, or some apps which are available for free, mental health apps furthermore have also opened doors for teenagers or other groups with less severe mental illnesses where primary care isn’t necessary.
When looking at this, mental health apps seem to be great and offer several advantages over traditional therapy. However, it’s not that easy. Professionals have voiced serious concern because, unfortunately, there are also downsides to many of these apps that might not be visible at first sight.
Serious concerns
One big issue is that most mental health apps were and are designed and developed without experts or the support of government funding. Reports show that apps developed by non-researchers and non-clinical teams do not strongly follow evidence-based guidelines and therefore can include in some instances inaccurate and consequently unsafe information.
Furthermore, another fact that is important to mention is that there is currently no ethical guideline for developing mental health apps. This raises considerable concerns about privacy and confidentiality. This is especially the case because the majority of mental health apps live outside of the jurisdiction of national or federal health regulations. This means that the protection of data collected by such an app is not guaranteed in the same way as information shared with a doctor or therapist. Furthermore, at this point, it’s also unclear how app stores regulate such apps and how they react to clinical concerns voiced to these apps.
How are these issues being addressed?
Currently, health systems and professional organizations are working on guiding consumers to high-quality apps. They are trying this by establishing guidelines for the design and development of apps. For example, the American Psychological Association has come up with an ethical guideline for health and mental health app developers.
Essential aspects of this guideline are protecting users‘ privacy, having control over what happens to their personal data, and making sure the apps are evidence-based. With this, the American Psychological Association aims to assure that no harmful apps are being put on the market.
In parallel to this, there are also attempts to create a framework for the assessment of those applications. These frameworks, for example, the Canadian Assessment Framework includes very similar criteria.
These cases show that government and health professionals are aware of the different areas of mental health apps that need improvement and clear rules. It is great to see that governments and experts are putting efforts into changing the situation. However, these things take time. Hence, in the meantime, potential users must be made aware of the risks and the criteria they should look for when considering such apps. Additionally, it should be made better visible by platforms like the app or google play store that if these apps they offer are evidence-based, effective and designed with experts and potential end-users.
How can I find a good mental health app?
While the review and ratings of products might usually be a good source of information, it isn’t necessarily ideal for mental health apps. Ratings can be unreliable, biased, and you never know how long a person has used the app and how well they stuck to the program and exercises. Some essential questions you can ask that can help find a reliable app are:
1. Were experts and or potential end-users involved in the development?
2. Is the app based on evidence?
3. What is the privacy policy of the app?
Unfortunately, it’s often not easy to find this important information, but thankfully, there are two websites that can help.
- One Mind Psyber Guide
PsyberGuide is a website dedicated to helping people choose reliable computer and device-assisted therapy for mental illnesses. Behind the website are an academic management team and a scientific board of directors. They come up with professional reviews of some of the apps available. Criteria for these reviews include credibility, transparency, and user experience. - Psychiatry.org
Psychiatry.org is the American Psychiatric Association website and reviews apps with the American Psychiatric Association App Evaluation Model. Their criteria are divided into background (if the app identifies ownership, funding sources, etc.), privacy and safety, clinical foundation, usability, and therapeutic goal. While these websites might be helpful, it’s important to remember that just because certain apps received a good review doesn’t mean that they will be effective and work for everyone. Furthermore, as soon as mental health issues become severe, it’s important to seek help from a professional as these apps cannot replace professional treatment just yet. I believe that we’re on a good way for mental health to become just as important as physical health. Moreover, it’s good to see that government and health organizations are actively working on making mental health apps safe and effective. With the aid of regulations and policies, such apps can become very valuable and could reach more people than traditional methods. I believe once rules and policies have been put in place, mental health apps can become a great contributor to achieving sustainable development goal number 3, „good health.“ Because after all, as the World Health Organization famously says, „There is no health without mental health.“
References
An Assessment Framework for e-Mental Health Apps in Canada: Results of a Modified Delphi Process. (2018). https://doi.org/10.1371/journal.pone.0152285
Bulatovych, D. (n.d.). Aspects to Consider When Developing a Mental Health App. Yalantis. Retrieved April 8, 2021, from https://yalantis.com/blog/mental-health-app-development/
Nature Editorial. (2020, December 17). How a torrent of COVID science changed research publishing — in seven charts. Nature. https://www.nature.com/articles/d41586-020-03564-y?error=cookies_not_supported&code=07942826-c49d-49aa-a02a-2017743a1e5e
Neary, M., S.M., Schuelle. (2018). State of the Field of Mental Health Apps. https://doi.org/10.1016/j.cbpra.2018.01.002
Perez, S. (2020, May 28). Meditation and mindfulness apps continue their surge amid pandemic. Tech Chrunch. https://techcrunch.com/2020/05/28/meditation-and-mindfulness-apps-continue-their-surge-amid-pandemic/
Psychotherapy in Switzerland. (2021, April 9). European Association for Psychotherapy. Retrieved April 09. 2021, from https://www.europsyche.org/situation-of-psychotherapy-in-variouscountries/switzerland/#:%7E:text=The%20average%20activity%20level%20of%20psychotherapists%3A%2054%25.%20There,CHF%20140%20to%20170%20per%20hour%20are%20recommended
Schraer, B. R. (2020, August 12). Coronavirus: Severe mental health problems rise amid pandemic. BBC News. https://www.bbc.com/news/health-53742121
World Health Organization. (2012, December 19). WHO | No physical health without mental health: lessons unlearned? WHO. https://www.who.int/bulletin/volumes/91/1/12-115063/en/
I believe that this blog is worth reading because it raises a very controversial but fundamental topic such as accessibility to mental health; with a special focus on the current pandemic’s impact and the technological means that allow more efficient connectivity in our modern world. In addition, through the blog, the author aims to analyze mental health apps to guide the reader to make better decisions when picking an app.
This blog picked my interest because I felt identified with the topic and found useful the guideline the author offered since I have never trusted such apps.
Overall the writing style used in the blog expresses clarity and conciseness; you know right away what’s the topic after the very first paragraph. Also, the text is very well distributed, coherent, and organized by subtitles. Nevertheless, paragraphs are very thick which reduces the space for the reader to breathe and assimilate the ideas.
Throughout the blog, the writer offers some interesting data that helps to raise the discussion point about the pandemic’s large impact on people’s mental health. I found her analysis very thoughtful. The writer considers the pros and downsides of using a mental health app from several perspectives such as economic, reliability, ethics, etc. Such analysis shows that the author keeps a very unbiased and neutral position regarding the topic which makes the reader feel that the information is reliable. However, I have identified that there are is some information that lacks some data such as location to make it understandable; e.g apps are used worldwide but there were some affirmations that seemed to belong to a specific place or country. As a reader I assumed was Switzerland but when finishing the reading I wasn’t fully sure.
The topic was for sure very interesting and I feel like I learned something which makes it more enjoyable. There are many points where I agreed with the writer. Also, I found some data that was very eye-opening to read and affirm such as online-rating that can’t be fully reliable. I would have liked to see more depth in the topic but overall I congratulate the author for raising such an important topic, especially during these hard times of pandemic.
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