How to find a mental health app that works

  • There are thousands of apps that claim to promote mental wellness, but not all of them are safe or effective. Illustration: Sophi Miyoko Gullbrants

This is a translation made by The newspaper of the note How to Find a Mental Health App That Works for Youoriginal from The New York Times.

With therapists in high demand today and long waiting lists making it difficult to find a provider, using a mental health app can seem like a tempting and relatively inexpensive way to get help.

These apps They claim to help with problems as varied as addiction, insomnia, anxiety and schizophrenia, often employing the use of tools such as games, chatbot therapy or mood diaries. But most are not regulated. While some are considered useful and safe, others may have shaky (or nonexistent) privacy policies and a lack of high-quality research to show that they live up to their privacy claims. marketing.

Stephen Schueller, executive director of One Mind PsyberGuide, a nonprofit project that reviews mental health apps, said the lack of regulation has created a “Wild West,” which was exacerbated when the Food and Drug Administration relaxed its requirements. for digital psychiatry products in 2020.

It’s hard to pin down the exact number of mental health apps available, but a 2017 estimate revealed there were at least 10,000 to download. And these digital products are becoming a lucrative business. Late last year, Deloitte Global predicted that global spending on mobile mental health apps would reach close to $500 million by 2022.

So how do you make an informed decision about whether or not to add one to your phone? For that, we consulted with several experts.

Who could benefit from a mental health app?

In general, mental health apps can help people gain insight into how their thoughts, feelings and actions interact with each other, explained Dr. John Torous, director of the Division of Digital Psychiatry at Beth Israel Deaconess Medical Center. They can also help facilitate the skills patients learn during therapy, he added.

Dr. Stephanie Collier, director of education in the Division of Geriatric Psychiatry at McLean Hospital, noted that mental health apps “can work well in conjunction with physical activity goals, such as step counters,” because exercise can help reduce anxiety and depressive symptoms.

“Similarly,” he said, “apps that teach skills like deep breathing can be helpful for anyone experiencing stress, whether the stress was the result of an anxiety disorder or simply circumstance.”

However, for some people, the apps don’t fit very well.

The apps they work best when people are motivated and have mild illness, Dr. Collier said. “People with moderate or severe depression may not be motivated enough by their illness to complete modules in a mobile app.”

Can mental health apps replace therapy?

No, and especially if you have symptoms of deterioration.

“These are not stand-alone treatments,” Collier cautioned. “But they can be effective when used in conjunction with therapy.”

Ideally, mental health apps teach skills or provide education, said Vaile Wright, senior director of health care innovation at the American Psychological Association.

“It could be this opening to thinking like, ‘Maybe I should get some more professional help,’” she said.

Dr. Torous offers his patients a free app called MindLAMP, which he created to enhance their mental health treatments. It tracks people’s sleep patterns, physical activities, and changes in symptoms; In addition, they can personalize the “activities” that therapists give to their patients.

Have these apps been vetted by a regulatory agency?

In most, no. The Food and Drug Administration regulates a small subset of apps that provide treatment or diagnosis, or are associated with regulated medical devices. But most mental wellness apps are not subject to US government oversight.

Therefore, some applications make claims of marketing unsubstantiated, experts warn, or worse, offer inaccurate and potentially damaging information.

“The number of products far exceeds the research evidence that exists,” said Dr. Schueller, 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, rather than by impartial outside groups.

Additionally, there is no requirement that all wellness apps comply with the Health Insurance Portability and Accountability Act, known as HIPAA, which governs the privacy of a patient’s health records.

In a recent article, Torous and colleagues examined regulatory gaps in digital health apps and revealed several issues that could arise, such as inaccurate phone numbers for helplines in the event of a suicide attempt crisis. The document also highlighted an earlier study that found that 29 of the 36 top-ranked apps for depression and smoking cessation shared user data with Facebook or Google, but only 12 accurately disclosed this in their privacy policies.

And in March, a study concluded that an app created to help people with schizophrenia limits no better than a placebo (in this case, a digital countdown timer).

All of these applications that claim to be effective in early or preliminary or feasibility studies probably need to study themselves with higher-quality science,” Torous said.

Finally, the fact that an application is popular in the market on-line does not mean that it will be safer or more effective.

How to go about choosing one?

“As a physician who has used apps in care for more than five years, it was always easy to understand which apps to pair with patients,” Torous said. “You really have to think about how we can respect people’s individual backgrounds, needs, and needs.”

Instead of looking for the “best app” or the one with the most ratings, try to make an informed decision about which would be the best option for you, he added.

One place to start looking is the Mind Apps website, which was created by doctors at Beth Israel Lahey Health in Massachusetts. It has reviewed more than 600 applications and is updated every six months. Verifiers look at factors like cost, security and privacy, and whether the app is backed by research.

Another website, One Mind PsyberGuide, evaluates health apps for credibility, user experience, and transparency of privacy practices. The project, which is affiliated with the University of California, Irvine, has more than 200 apps in its database and each one is reviewed annually.

What to look for in an app’s privacy policy?

Although MindApps and One Mind Psyberguide present an overview of an app’s privacy policy, you may want to delve into the details on your own.

Look at what kind of information it collects, its security measures and if it sells information to third parties or uses information for advertisements, Collier specified.

According to a 2019 study, less than half of mobile apps for depression have a privacy policy, and most privacy policies are provided only after users enter their data.

“It’s no wonder some people have reservations about using mobile apps like this when they don’t know if their data is being used or what,” said study lead author Kristen O’Loughlin, a graduate research assistant at the Virginia Commonwealth University School of Medicine.

Choose your app based on the information available and your own comfort level with the disclosure of personal information, he added.

Which apps are trusted?

The answer may depend on who you ask. But all the experts spoke highly of mental wellness apps developed by the federal government, like PTSD Coach; Mindfulness Coach; and CPT Coach, which is for people who are practicing cognitive processing therapy with a professional mental health care provider.

These apps are not only well researched but also free with no hidden costs. They have excellent privacy policies and state that personal information will never be shared with a third party.

In addition to those apps, Collier recommends:

DBT Coach

CBT Thought Diary

Breathe2Relax (an app designed by an agency of the US Department of Defense that teaches abdominal breathing)

Virtual Hope Box (an app produced by the Defense Health Agency that offers support in emotional regulation and stress reduction)

For more tips, check out this list of apps on the UC San Francisco Department of Psychiatry and Behavioral Sciences website. The list, created in consultation with Dr. Schueller, includes several free options.

Translated by José Silva

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