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.
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.
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