7 Questions to Ask When Using Mental Health Apps

7 Questions to Ask When Using Mental Health Apps

Source: George Dolgikh/Pexels

Source: George Dolgikh/Pexels

The smartphone app marketplace is filled with thousands of mental health apps that claim to help with anxiety, depression, sleep, mindfulness and more. How can one determine which apps are reliable and potentially useful?

While apps can be useful tools for personal growth and well-being, recent research has found that apps with real-world studies to back up their claims are limited. A 2020 study found that only 2% of wellness and stress-related apps had research studies to support their claims. Another study in 2022 found that only 3.4% of apps for anxiety and depression were supported by clinical studies or real-world evidence. A new 2022 review of mental health apps published in Open JAMA Network examined 578 mental health smartphone apps and found that e.gthe vast majority (91%) are made by for-profit companies, 4% were created by the government and 4% by non-profit organizations.

Researchers found that the top five features of smartphone apps for mental health were psychoeducation, goal setting/habits, mindfulness, journaling and mood tracking. The three most common problems targeted by the apps were drug use, such as smoking, stress and anxiety, and mood disorders. It was least common for apps to use sensor data or biofeedback, although this feature would make the apps more innovative and could provide real-time feedback.

Camacho et al., 2022

Source: Camacho et al., 2022

Given that there are thousands of mental health apps and so few of them make research-backed claims, it’s important to use unbiased third-party resources to research mental health smartphone apps.

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Here are two resources for researching wellness and mental health apps:

One Mind PsyberGuide is a free and independent online review site that helps shine a light on the credibility, transparency and user experience of mental health apps. Some apps are also reviewed by professionals. It has been written about the guide and reviewed by clinicians, who found it to be comprehensive and user-friendly compared to other app rating platforms (eg, American Psychological Association and Anxiety and Depression Association of America app ratings, Enlight, MARS, mHAD, Mind Tools, and ORCHA).

MIND apps is a searchable database developed by a team at Harvard Medical School to empower the user to make informed decisions about apps. It describes features such as costs, privacy, clinical evidence, commitment and clinical conditions.

Here are seven questions to research before using a mental health app, along with the two resources above.

1. Will the app keep my information private and secure?

  • What elements of my profile will be public?
  • Will the company share or sell my data or use it for research?
  • Are there adequate security measures? Have there been any previous data leaks of this app?
  • How would I feel if there was a data leak of the information collected by the app?

The current unfortunate reality is that it is almost impossible for data security to be foolproof and almost impossible to know exactly what will happen to your data or where it might end up. Almost half of the apps shared personal health information with third parties. A recent study by the Mozilla Foundation assessed the privacy and security of 32 popular mental health and prayer apps and found that 87.5% had serious privacy issues. About 77% of the apps in the study had a privacy policy. But having a privacy policy doesn’t mean companies make it clear how your data may be shared or used. Consumer Reports conducted a study of seven popular mental health apps and found that some were not following their privacy policies.

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2. Is the app backed by scientific research or clinical evidence?

Both review sites will indicate whether there is clinical evidence or at least scientific basis to support an app’s claims. One Mind PsyberGuide gives apps a credibility score, which is based on research evidence for the app itself, research principles, app development and ongoing maintenance.

3. Will the app allow me to email or export my data?

A useful feature is that your data can be shared, to yourself or your doctor, or easily exported for your own records. Researchers found that about a third of apps (30%) allow users to email or export their data. Exporting data can be a useful feature to save your data, especially if the app is discontinued.

4. Will the app allow me to easily delete my data if I want to stop using the app?

Another consideration is whether the app allows you to delete your data when you decide you don’t want to continue using the app.

5. Will the app allow me to opt out of data collection?

Apps should be clear and upfront about asking for your consent to collect your data. Many apps will collect user data for academic research or other purposes by default, without asking for clear user consent or the ability to opt out. One app company in the Consumer Reports study referred to sharing data with several academic research institutions as “data processing”.

6. Which features require an in-app purchase or subscription?

About 88% of apps were free to download, but only 39% were completely free; 44% had in-app purchases and 34% required a subscription to unlock all features.

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7. Is the app available for my needs?

About 65% of the apps could work offline without an internet connection. About 54% had at least one accessibility feature, such as adjustable text size, text-to-speech, or speech-to-text capabilities.

It’s important to research mental health apps beforehand, especially since sensitive private data is likely to be held on your account. These questions can help you weigh the potential risks and benefits so you can decide which app is right for you.

Copyright © 2022 Marlynn Wei, MD, PLLC.

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