One day we might prescribe mobile phone apps for mental health conditions…..but not yet

Prescribe app

 

I was sent this paper today and decided to share my thoughts on it straight away.

The authors of the paper set out to find mobile phone apps that could realistically (because of evidence they worked) be prescribed to patients with different health conditions. One group of patients they were interested in was those with mental health problems.

They authors looked to the research evidence to find apps that had undergone appropriate effectiveness testing in randomised controlled trials (the gold standard for testing a health intervention) and were also available for people to download on their phones.

Whilst quite a few mental health related apps have been reviewed over the past decade, once you limit it down to those that a) have been shown to be beneficial and b) are readily available, the final list was disappointing.

SuperBetter (basic and fortified) version – an app that uses gaming principles (e.g. leveling up) to help individuals ‘achieve personal growth and tackle real-life challenges’. Users have used the app to adopt new habits, develop a talent/skill, strengthen a relationship, complete projects, pursue goals, overcome mental and physical conditions, and overcome life challenges like finding a new job. Use of the app has been shown to reduce depression symptoms, but attrition (i.e. number of people who stop using the app) is high.

Managing Depression – is one of a number of apps available from This Way Up, a reputable Australian provider of online wellbeing programs. Many of their programs are available as both web-based programs but also mobile phone apps (e.g. depression, generalised anxiety, mixed anxiety and depression, OCD, panic, social phobia). Evidence for these programs is good, but there is a cost for using them – $59 AUD.

A-CHESS – a mobile app providing ongoing support for people leaving alcohol rehabilitation. Not available in Australia.

 

You might be thinking – “….but Gareth recommends other apps in his other posts. Why aren’t these on the list?”

Excellent observation. Let me clarify…

1) very few of the thousands of mobile phone apps that have been developed for mental health problems have undergone rigorous evaluation. As you can see above, if I limited my suggestions to only those with published research evidence and readily available, there would be virtually nothing to suggest.

2) there are lots of apps that have been developed by reputable groups (e.g. university and mental health foundations) that are based on sound principles of mental health treatment but have yet to be formally evaluated. I feel comfortable recommending these apps, but with the proviso that they may not be beneficial and you might need to seek out professional advice if your mental health problems are not improving. Basically, it is a “see if it helps you, and if not, reach out to us here at Health, Counselling and Disability Services“.

3) many of the app suggestions I make are for apps that teach skills that are useful for health and wellbeing (e.g. this breathing app by Reachout). These apps aren’t intended to be a complete standalone treatment for mental health problems, but rather a way of learning some valuable wellbeing skills. Again, you may need to use the app for a while

4) what I will try to do is steer you towards apps that I think might have some value, and away from those that I think will be ineffective or exploitative (i.e. expensive but untested).

 

Determining whether a mobile app might be helpful for your health condition, is similar to evaluating the quality of health websites.

Does the content look credible? Are their sources clearly cited? Are there references to medical research that you can see? – if the content isn’t backed up by some legitimate science, then steer clear.

Does the source look credible? Is the app made by a known university or reputable organisation? – if you can’t easily identify who has made the app and why, steer clear.

Does the content look biased? Could the content have been created by someone that is simply trying to sell you something (e.g. an advertisement), or does it seem very one-sided? – apps that suggest only their method is effective for treating your health condition should be avoided.

Is the app being kept up-to-date? Has the app been updated recently? – apps that have been left for a long period might simply be there to generate a small income for their developers.

Does the app link to additional resources? – if the app has no additional links to reputable sources of information, steer clear.

 

If you’ve found a mental health focused app, and you’d like advice on whether it might be useful, feel free to email me – gareth.furber@flinders.edu.au

 

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Health Information Mental Health Mobile Apps Research and Reports

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