With physicians in high demand and long waiting lists that make it difficult to find a provider, using a mental health app seems like an exciting and relatively inexpensive way to get help.
These apps claim to help with a variety of problems such as addiction, insomnia, anxiety and schizophrenia, often using tools such as games, therapy chatbots or mood-tracking diaries. But most are uncontrollable. While some may be considered useful and secure, others may have volatile (or non-existent) privacy policies and a lack of high-quality research that demonstrates that applications live up to their marketing claims.
Stephen Schuler, executive director of One Mind CyberGuide, a nonprofit project that reviews mental health applications, said the lack of regulation has created a “wild waste” that has increased when the Food and Drug Administration required digital psychiatry for its products. Had loosened. 2020. 2020.
It is difficult to determine the exact number of available mental health applications, but an estimate of at least 10,000 is available for download in 2017. And these digital products are becoming a lucrative business. At the end of last year, Deloitte Global predicted that by 2022, worldwide spending on mobile mental health applications would reach close to $ 500 million.
So how do you make an informed decision about whether to add one to your phone? We asked some experts for guidance.
Who can benefit from a mental health application?
In general, mental health applications can help people gain an understanding of how their thoughts, feelings, and actions interact with each other. John Torres, director of the Department of Digital Psychiatry at Beth Israel Decones Medical Center. They can also help simplify the skills that patients learn during treatment, he added.
Dr. Stephanie Collier, director of education for the Department of Aging Psychiatry at McLean Hospital, noted that mental health applications can work well with “physical activity goals, such as step counters” because exercise can help reduce anxiety and depressive symptoms.
“Well,” she said, “as well as apps that teach skills such as deep breathing can be helpful for anyone experiencing stress – whether stress is the result of an anxiety disorder or just circumstances.”
For some, however, apps may not be the best fit.
Apps work best when people are motivated and have a mild illness, Dr. Collier said. “People with moderate or severe depression may not have enough motivation to complete modules on the mobile app due to their illness.”
Can Mental Health Apps Be an Alternative to Treatment?
No, and especially if you have symptoms of weakness.
“This is not the only treatment,” said Dr. Collier said. “But they can be effective when used in conjunction with therapy.”
Weill Wright, senior director of health care innovation at the American Psychological Association, said that ideally, mental health applications teach or provide skills.
“Maybe I should seek some more professional help,” she said.
Dr. Torres offers his patients a free application called MindLAMP, which he created to enhance their mental health treatment. It tracks changes in people’s sleep patterns, physical activities and symptoms; It can also customize the “homework” that the therapist gives to their patients.
Have these apps been investigated by any regulatory agency?
Mostly, no. The Food and Drug Administration controls a small subset of apps that provide treatment or diagnosis or are associated with regulated medical devices. But most mental wellness applications are not subject to government oversight.
Thus, some applications make unsubstantiated marketing claims, experts warn or even provide worse, inaccurate and potentially harmful information.
Dr. Schuler, who is also a clinical psychologist and associate professor at the University of California, Irvine. “Unfortunately much of the research that exists in this area is done internally by companies,” he added, replacing the outside groups with impartiality.
Furthermore, there is no requirement that all wellness apps be known as the Health Insurance Portability and Accountability Act, HIPAA, which governs the confidentiality of a patient’s health records.
In a recent paper, Dr. Torres and his colleagues investigated regulatory loopholes in digital health apps, which could lead to a variety of problems, such as an inaccurate phone number for a suicide emergency helpline. The paper also published a previous study which found that 29 of the 36 top ranked apps for depression and smoking cessation shared user data with Facebook or Google, but only 12 disclosed this explicitly in their privacy policies.
And in March, a study found that an app designed to help people with schizophrenia could not perform better than a placebo (in this case, a digital countdown timer).
“All of these applications, which claim to be effective in initial or preliminary or feasibility studies, need to study themselves with high-quality science,” said Dr. Toros said.
Lastly, just because an application is popular in the online marketplace does not mean that it will be more secure or more effective.
How do you go about choosing one?
“As a therapist who has used apps in well-care for over five years, it has always been difficult to understand which applications match up with patients,” said Dr. Toros said. “You really have to think about how we can respect people’s personal backgrounds, preferences and needs.”
Instead of trying to find the “best app” or the one with the highest ratings, try to make an informed decision about which app will be the best match for you, he added.
One place to start research is the Mind Apps website, created by physicians at Beth Israel Lahe Health in Massachusetts. It has reviewed over 600 apps and is updated every six months. Critics look at such factors Price, security and privacy concerns and whether supported by application research.
Another website, One Mind CyberGuide, evaluates health applications for reliability, user experience and transparency of privacy practices. The project, which is affiliated with the University of California, Irvine, has more than 200 applications in its database and is reviewed annually.
See what kind of information it collects, its security measures and the information it sells to third parties that use the information for advertising. Collier said.
Kristen O’Loughlin, lead author of the study, said: “It’s no surprise that some people have reservations about using mobile apps this way when you don’t know how or why your data is used.” Virginia Commonwealth University School of Medicine.
Choose your application based on the information available and disclose personal information based on your own comfort level, she added.
Which apps are reputable?
The answer to this question may depend on who you ask. But all the experts talked a lot about the mental wellness apps developed by the federal government like PTSD Coach; Mindfulness Coach; And CPT coaches, which are for people who are practicing cognitive process therapy with a professional mental health care provider.
These apps are not only well-studied but also free, with no hidden costs. They have excellent privacy policies and state that personal information will never be shared with third parties.
In addition to those apps, Dr. Collier recommends:
Breathe2Relax (Application designed by the U.S. Department of Defense agency to teach abdominal breathing)
Virtual Hop Box (an application produced by the Defense Health Agency that supports emotional regulation and stress reduction)
For more suggestions, check out this list of applications on the website of the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco. The list prepared in consultation with Dr. Schueler, includes many free options.