Mental Health Apps: Snake-oil or science?

A Boreal Wellness Centres Blog Post
A Wild West of “Snake Oil”

In recent years, numerous mental health apps have been developed and made available to smartphone users. These apps aim to improve mental health and well-being, ranging from guiding mental illness recovery to encouraging beneficial habits that improve emotional health. However, most mental health apps don’t have a lot of proven science to support their claims and this can result in a “wild west” of persuasively marketed snake oil.

Mobile Usage Is Growing Fast

Look around you when you’re in public and it should come as no surprise that smartphone ownership is growing in Canada—faces buried in phones while walking, at the grocery store, on public transit…it can seem that if you don’t have a phone, you’re missing out.

What is surprising is the rate at which it is growing. As part of its 2016 General Social Survey, Statistics Canada proved that mobile technology has permeated the lives of Canadians.1

According to the survey:

  • 76 percent of Canadians owned a smartphone in 2016, a 38% increase from 2014;
  • 94 percent of 15 to 34-year-olds surveyed reported owning a smartphone along with 69 percent of 55 to 64-year-olds and 18 percent of those 75 years or older;
  • 71 percent owned a laptop or netbook;
  • 54 percent had a tablet or e-reader and 50 percent a desktop computer.

Clearly for more than taking selfies and posting on Facebook, smartphones have become a key part of the fabric of day-to-day life.

Do Mental Health Apps Work?

Mobile health apps aimed towards patients are an emerging field. Their potential for improving self-management of chronic conditions is significant. Just as technology has transformed other aspects of our lives, people are increasingly tapping it for health needs.

Experts believe that technology has a lot of potential for clients and clinicians alike. A few of the advantages of mobile care include:

  • convenience
  • anonymity
  • lower cost
  • services available to more people (e.g. rural areas)
  • engagement (technology-supported treatment is sometimes more appealing than traditional methods).
  • 24/7 availability
  • support (technology can complement traditional therapy by extending an in-person session, reinforcing new skills, and providing support and monitoring.

Though evidence supports the use of smartphone-based apps as a vehicle for mental health treatment delivery, there remains debate around whether these apps have demonstrated high efficacy. This is due to both the lack of evidence-based mobile apps available on the market, and the lack of studies that bring together the disorder-specific silos of evidence that do exist.

A 2015 meta-analysis led by Harvard Medical School psychiatrist John Torous, MD, for example, looked at 10 studies examining the use of apps in the treatment of mood disorders. The analysis found that individuals who used these apps reported improved depressive symptoms.2 And a 2013 study led by University of New South Wales psychologist Tara Donker, PhD, found that participants who used apps reported they were a useful and convenient way to get self-help for mental health concerns and disorders.3 Similar studies have found positive results for mental health apps based on principles of Cognitive Behaviour Therapy and related models of mental well-being.4

The most well-established and frequently researched mental health apps are those designed for preventing or managing anxiety and depression. There is also promising evidence for other mental health disorders including:

  • Depression
  • Anxiety
  • Sleep disorders
  • Eating disorders
  • Pain disorders
  • Grief
  • Self-harm thoughts, and
  • Obsessive-compulsive disorder.
The Bottom Line

There is an enormous worldwide need for better preventative mental health, and mental health apps that target mental health and well-being provide for exciting opportunities to deliver high-efficacy mental health interventions.

Despite their potential, however, the scientific study of app claims and underlying theoretical models, there are many caveats remaining and the industry is still in its infancy.

With more rigorous research, formal standards, certification, and health association regulation and oversight, the future of mental health technologies looks bright.

References

  1. Statistics Canada (2016). General Social Survey Canadians at Work and Home (GSS). Statistics Canada. Retrieved online November 1, 2018 from: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getInstanceList&Id=302914
  2. Torous, J. (ed.) (2017). Internet interventions, technologies and digital innovations for mental health and behaviour change. 4(2).
  3. Donker T., Petrie K., Proudfoot J., Clarke J., Birch M.R., & Christensen, H. (2013). Smartphones for smarter delivery of mental health programs: a systematic review. Journal of Medical Internet Research, 15(11):247.
  4. Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2016). Mental health smartphone apps: Review and evidence-based recommendations for future developments. Journal of Medical Internet Research. 3(1):7.

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