Phone Apps Miss Mental Health Opportunities

Phone Apps Miss Mental Health Opportunities

Close-up of young woman using mobile phone on Victoria Harbor seafront with urban city skyline in background
Close-up of young woman using mobile phone on Victoria Harbor seafront with urban city skyline in background

Although there are thousands of mental health smartphone apps, research suggests that they often provide overlapping features, provide insufficient privacy information, and do not target patients who may need them most.

Among the more than 500 apps studied, most offered basic features such as psychoeducation, goal tracking and mindfulness, and fewer included innovative features such as biofeedback or specialized therapies.

Measures of app popularity, such as consumer star ratings or number of downloads, did not correlate well with privacy and effectiveness, according to the study published in Open JAMA Network.

“Findings from this cross-sectional study suggest that current app marketplaces lack diversity in their offerings and fail to implement potentially effective features,” report Erica Camacho and colleagues from Beth Israel Deaconess Medical Center in Boston, Massachusetts.

“Another challenge for the app space is that readily available metrics like star ratings don’t take into account privacy capabilities.

“Therefore, clinicians and patients must look to apps beyond such measures to ensure the discovery of apps that both fit their unique needs and protect their privacy.”

The COVID-19 pandemic has led to increased reliance on digital tools for the delivery of mental health care, the researchers say.

With more than 10,000 mental health-related apps available today, they emphasize the importance of being able to choose a safe and effective app.

The team therefore developed a large public database of mental health apps, the M-Health Index and Navigation Database (MIND).

MIND is derived from the principles behind the American Psychiatric Association’s app evaluation framework and evaluates apps across 105 unique dimensions.

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Between January and July 2022, Camacho et al asked raters trained using MIND to rate 578 mental health apps available on the Apple app or Google Play stores.

Of these, 27.7% were only available on iOS, 26.6% were only available on Android, and 45.7% were available on both.

Although 88% were free to download, 44% involved in-app purchases and 34% required subscriptions to unlock full app functionality.

Overall, 77% of apps had a privacy policy, but nearly half (44%) shared personal health information with third parties.

The apps offered 22 unique features related to therapeutic areas. Of these, psychoeducation was most common, with 41%, followed by goal setting/habit and mindfulness, each with 38%.

Only 1% of apps provided biofeedback with sensor data, 2% Acceptance and Commitment Therapy and another 2% Dialectical Behavior Therapy.

The three most common types of conditions the apps claimed to help treat were substance abuse related to smoking or tobacco (33%), stress and anxiety (28%), and non-serious mood disorders (20%). Only 13 apps – equivalent to just 2% – were created to deal with schizophrenia.

Apps that collected biodata, geolocation data, and accessed cameras and microphones were more likely than others to implement privacy and security measures.

Privacy scores did not correlate with consumer star ratings and only weakly correlated with download scores, meaning that popularity metrics provided little help in identifying those with greater privacy.

“The lack of correlation between privacy scores and consumer ratings on both the iOS App Store and Google Play Store also suggests that consumers may not be aware of or seek out apps based on privacy features—underscoring an opportunity for further education or even regulation,” researchers report .

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Nevertheless, they add that it is reassuring that the majority of apps had a privacy policy.

“With so many apps in the commercial marketplaces, clinicians and patients can now be more discerning in what they seek from a given app,” the investigators maintain.

They add that publicly available app libraries and validated app evaluation frameworks such as MIND are innovative tools to support users in their app selection.

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