Technology and Mental Health: How do we make sense of mental health apps?

Sad female runs out of the mobile phone. Girl feels vulnerable and lonely on social online spaces. Social media influence on mental health and wellness. Vector illustration

Over the past decade, smartphones have become an integral part of our social and occupational environments. Medical professionals have transitioned from pocket PDAs to utilizing multiple applications (apps) downloaded onto smartphones. Recently, apps have been created to target almost all activities of daily living, from helping with finances and travel arrangements to improving one’s physical and mental health. Per the American Psychological Association, around 20,000 mental health apps are currently available.

There are obvious benefits to utilizing mental health apps. From limited numbers of mental health professionals to the physical distance and insurance costs, there are multiple barriers to obtaining care. One can easily imagine how an app can be utilized to improve access to care by bringing care directly to the patient. Another benefit is the flexibility of use. Users can open up an app at any time of day and choose their preferred style of engagement, such as self-help vs guided programs. The cost is another factor. The one-time cost of purchasing an app or low monthly payment is very appealing to many. Last but not least, as the stigma of mental illness still exists, one can avoid the potential shame of seeking mental health treatment in the community by retaining their anonymity via using an app.

There are some risks, too. Since apps are technology-based, they can be listed on the app marketplace without much vetting that is usually required within the medical field. It is also unclear to what extent evidence-based practice guidelines are utilized when creating these apps. The Food and Drug Administration provides some oversight based on the type of platform used and its risk to the public. The Federal Trade Commission also plays a role in minimizing deceptive advertising. However, outside of these two, there is no significant vetting or regulation. There is also a concern for the privacy of user data. Recent studies have indicated that many apps shared data with third parties, and few of them disclosed this fact to their users.

Given the multitude of apps available, how do you make sense of them and choose what is best for your patient? While this is not intended to serve as an official endorsement, there are two useful resources that are designed to assist mental health professionals in navigating this new realm. The American Psychiatric Association has created a tool called the APA APP Advisor to help make a more informed decision when choosing or suggesting an app. The APA APP Advisor provides a framework of questions that assists the reviewer in deciding whether an app is safe and useful. Another resource is PsyberGuide. This is a non-profit organization that operates out of the University of California, Irvine and Northwestern University. This organization analyzes the strength of the scientific evidence that supports these mental health apps and writes its own reviews of these apps based on its findings.

When faced with a difficult decision of whether to recommend an app, mental health professionals need as many tools as possible. In addition to tools such as the APA APP Advisor and PsyberGuide, reviewers are also encouraged to download the apps to try them out themselves and make a clinical judgment on whether they believe the app is helpful or harmful to their patients. When in doubt, remember the Hippocratic message of “Do No Harm.”

While technology has revolutionized the way care is delivered, it can also cause harm if not utilized carefully and thoughtfully. Therefore, it is vital that mental health professionals have enough tools and resources available to assist them with decision-making and patient care.

At Orbit Health, our providers are experts in mental health and technology. If you have any questions about how to navigate mental health apps or are looking for providers skilled in mental health and technology, reach out to Orbit Health today.

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