One of the biggest growth areas in e-mental health resources has been the development and use of mobile mental health apps for smartphones and tablet devices. Such apps are being downloaded at increasing rates, but there have been questions about their efficacy and the research methodologies used to examine this. A review of the major app marketplaces, the Apple App Store and Google Play store, was conducted to locate apps claiming to offer a therapeutic treatment for depression and/or anxiety, and have research evidence for their effectiveness, according to their app store descriptions. App store descriptions were also analyzed to determine whether the app had been developed with mental health expert input; whether they had been developed in association with a government body, academic institution, or medical facility; and, whether or not they were free to download. Overall, 3.41% of apps had research to justify their claims of effectiveness, with the majority of that research undertaken by those involved in the development of the app. Other results indicated that 30.38% of shortlisted apps claimed to have expert development input; 20.48% had an affiliation with a government body, academic institution, or medical facility; and, 74.06% were free to download. Future research must consider other methodologies that may facilitate more research being completed on a greater number of apps, and future development needs to incorporate greater levels of input by mental health experts. Ways in which app stores could play a key role in encouraging more scientific research into the effectiveness of the mental health apps they sell are discussed.

The mental health literacy (MHL) of rural adolescents has rarely been investigated. This study examined the MHL of 122 rural‐based adolescents (49 males, 73 females) aged 12–18 years (M = 16, SD = 1) using written vignettes and short films to examine knowledge about depression. For the written vignettes, 68% of the rural adolescents were able to correctly identify someone with depression, which is similar to the findings for metropolitan adolescents; however, knowledge about recovery times and avenues of assistance were below that of their metropolitan peers. Participants were less likely to correctly diagnose depression when suicidal intent was not expressed and when the scenario was presented in the more naturalistic form of a film. This finding raises questions about the place of films and written vignettes in future MHL research.

Demand for telehealth services with psychologists and other health professionals has increased during the COVID-19 pandemic, and as a result some members of the community are unable to access face-to-face assistance for trauma-related mental health issues. This has led to an increase in usage of alternative digital mental health options such as smartphone apps and other Internet-enabled assistance. The Australian Federal Government has promoted digital mental health options for many years, and it has a comprehensive architecture of digital resources in place, but will it be enough to deal with the expected rise in symptoms of trauma among the general population in the wake of COVID-19?

Background Mobile mental health apps have become ubiquitous tools to assist people in managing symptoms of anxiety and depression. However, due to the lack of research and expert input that has accompanied the development of most apps, concerns have been raised by clinicians, researchers, and government authorities about their efficacy. Objective This review aimed to estimate the proportion of mental health apps offering comprehensive therapeutic treatments for anxiety and/or depression available in the app stores that have been developed using evidence-based frameworks. It also aimed to estimate the proportions of specific frameworks being used in an effort to understand which frameworks are having the most influence on app developers in this area. Methods A systematic review of the Apple App Store and Google Play store was performed to identify apps offering comprehensive therapeutic interventions that targeted anxiety and/or depression. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was adapted to guide this approach. Results Of the 293 apps shortlisted as offering a therapeutic treatment for anxiety and/or depression, 162 (55.3%) mentioned an evidence-based framework in their app store descriptions. Of the 293 apps, 88 (30.0%) claimed to use cognitive behavioral therapy techniques, 46 (15.7%) claimed to use mindfulness, 27 (9.2%) claimed to use positive psychology, 10 (3.4%) claimed to use dialectical behavior therapy, 5 (1.7%) claimed to use acceptance and commitment therapy, and 20 (6.8%) claimed to use other techniques. Of the 162 apps that claimed to use a theoretical framework, only 10 (6.2%) had published evidence for their efficacy. Conclusions The current proportion of apps developed using evidence-based frameworks is unacceptably low, and those without tested frameworks may be ineffective, or worse, pose a risk of harm to users. Future research should establish what other factors work in conjunction with evidence-based frameworks to produce efficacious mental health apps.

Objectives: The increase in ownership of smartphones and tablet devices has seen a worldwide government push, championed by the World Health Organization, towards digital healthcare services generally. Mental health has been a strong presence in the digitisation of healthcare because of the potential to solve some of the difficulties in accessing face-to-face services. This review summarises the recent history of e-mental health services and illuminates two very different paths. The first is the considerable amount of research that has proven the effectiveness of many online mental health programmes for personal computers and laptops, resulting in widespread acceptance of their ability to make a contribution in an individual’s recovery from anxiety and depression. The second is associated with the more recent development of apps for smartphones and tablet devices and the contrasting paucity of research that has accompanied this burgeoning area of e-mental health. This review also outlines the current state of play for research into the effectiveness of mobile mental health apps for anxiety and depression, including issues associated with methodology, and offers sources of practical advice for clinicians wanting more information about these new digital tools. Conclusion: Research into the effectiveness of mental health apps is lacking, and the majority have no evidence of efficacy. Clinicians need to be aware of what apps have such evidence and should exercise caution when recommending apps to patients. Suggestions are offered on the direction of future research, including an appeal to further include clinicians in the development and efficacy testing of mental health apps.

Practicing psychologists are being faced with the reality that mobile mental health apps for smartphones and tablet devices are increasing in popularity. This growth area within e-mental health has been well documented in Professional Psychology: Research and Practice. This article provides an update on the issues of safety and efficacy in mental health app development, two of the biggest concerns that practicing psychologists have about these new digital tools. Governments and medical authorities are wrestling with how to regulate the health app market to avoid harm to users. At the same time, a lack of research into the efficacy and effectiveness of most mental health apps in the various app stores leaves clinicians and consumers with uncertainty. The vast majority of the limited research to date has been completed by those involved in an app's development. Further independent research and replication are required to demonstrate legitimacy and increase the acceptance of mental health apps as valid sources of therapy. Complicating this issue is disparity about an acceptable methodology for examining the effectiveness of a mental health app. This article proposes a new approach to incorporate multiple baseline single-case designs to increase the amount of evidence and to guide larger-scale randomized controlled trials, something that could and should include practicing psychologists. This novel approach also proposes that mental health apps undergo a new "certification" process with the participation of app store marketplaces. Public Significance StatementTwo of the biggest concerns that clinicians have about mental health mobile applications (apps) are their safety and efficacy. This article examines the key issues of the difficulties of regulation and certification, the potential for apps to cause harm to their users, the complexities of organizing large-scale studies to test for efficacy and effectiveness, and the feasibility of increasing the evidence base by using novel research methods.

Background The use of mental health mobile apps to treat anxiety and depression is widespread and growing. Several reviews have found that most of these apps do not have published evidence for their effectiveness, and existing research has primarily been undertaken by individuals and institutions that have an association with the app being tested. Another reason for the lack of research is that the execution of the traditional randomized controlled trial is time prohibitive in this profit-driven industry. Consequently, there have been calls for different methodologies to be considered. One such methodology is the single-case design, of which, to the best of our knowledge, no peer-reviewed published example with mental health apps for anxiety and/or depression could be located. Objective The aim of this study is to examine the effectiveness of 5 apps (Destressify, MoodMission, Smiling Mind, MindShift, and SuperBetter) in reducing symptoms of anxiety and/or depression. These apps were selected because they are publicly available, free to download, and have published evidence of efficacy. Methods A multiple baseline across-individuals design will be employed. A total of 50 participants will be recruited (10 for each app) who will provide baseline data for 20 days. The sequential introduction of an intervention phase will commence once baseline readings have indicated stability in the measures of participants’ mental health and will proceed for 10 weeks. Postintervention measurements will continue for a further 20 days. Participants will be required to provide daily subjective units of distress (SUDS) ratings via SMS text messages and will complete other measures at 5 different time points, including at 6-month follow-up. SUDS data will be examined via a time series analysis across the experimental phases. Individual analyses of outcome measures will be conducted to detect clinically significant changes in symptoms using the statistical approach proposed by Jacobson and Truax. Participants will rate their app on several domains at the end of the intervention. Results Participant recruitment commenced in January 2020. The postintervention phase will be completed by June 2020. Data analysis will commence after this. A write-up for publication is expected to be completed after the follow-up phase is finalized in January 2021. Conclusions If the apps prove to be effective as hypothesized, this will provide collateral evidence of their efficacy. It could also provide the benefits of (1) improved access to mental health services for people in rural areas, lower socioeconomic groups, and children and adolescents and (2) improved capacity to enhance face-to-face therapy through digital homework tasks that can be shared instantly with a therapist. It is also anticipated that this methodology could be used for other mental health apps to bolster the independent evidence base for this mode of treatment. International Registered Report Identifier (IRRID) PRR1-10.2196/17159

With the COVID-19 pandemic confronting health systems worldwide, medical practitioners are treating a myriad of physical symptoms that have, sadly, killed many thousands of people. There are signs that the public is also experiencing psychological trauma as they attempt to navigate their way through the COVID-19 restrictions impinging on many aspects of society. With unprecedented demand for health professionals' time, people who are unable to access face-to-face assistance are turning to smartphone apps to help them deal with symptoms of trauma. However, the evidence for smartphone apps to treat trauma is limited, and clinicians need to be aware of the limitations and unresolved issues involved in using mental health apps.