Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

Abstract

BackgroundThe number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available.ObjectiveTo guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps.MethodsA literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design.ResultsSixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp.ConclusionsRandomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

Patients’ perspectives about the design of a mobile application for psychotic disorders

“…Few steps to perform actions, memory aids, simple screen design and short sentences minimizing abstract thinking are crucial to overcome possible cognitive issues of this population. A recent review (Bakker, Kazantzis, Rickwood, & Rickard, 2016) pointed out sixteen recommendations for mental health smartphone apps, such as: cognitive behavioural therapy based interventions, automated tailoring, recommend activities, especially nontechnology-based ones (behavioural activation), or links to crisis support services. Experimental trials to establish efficacy were also mentioned.…”

A systematic review of the psychometric properties, usability and clinical impacts of mobile mood-monitoring applications in young people

“…Studies from the adult literature are somewhat congruent in supporting the usability of mood-monitoring apps (Bardram et al 2013), though evidence suggests that increasing age (e.g. 'middle age') may lower likelihood of mood-monitoring app use (Depp et al 2012).…”

“…internal consistency (Palmier-Claus et al 2012) and concurrent validity (Faurholt-Jepsen et al 2014) of these apps. There is also evidence for usability (Bardram et al 2013). Participation rates are generally high across studies sampling adults, ranging from 65% (Depp et al 2015) to 88% , though Depp et al (2012) reported much higher completion rates for paper and pencil compared with app measures (82.9% v. 42.1%).…”

“…Participation rates are generally high across studies sampling adults, ranging from 65% (Depp et al 2015) to 88% , though Depp et al (2012) reported much higher completion rates for paper and pencil compared with app measures (82.9% v. 42.1%). Evidence also suggests that apps may help people with mental health problems to monitor triggers (Bardram et al 2013), that the capacity to convey experience can be therapeutic, and that apps could be a useful tool for improving patientclinician communication .…”

Best of Times, Worst of Times: Occupational Mental Health Research in India

“…Tools developed for the assessment of occupational mental health can be useful for advancing evidence-based research in the area. The concepts of occupational mental health can be integrated to the current revolution in mental healthcare being ushered in by smartphone-based mental health apps [42] which hold a lot of promise for the general public. This becomes even more significant in places like India which suffer from a huge treatment gap [43].…”