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7 Questions to Ask When Using Mental Health Apps

New research finds only 2% of wellness apps have research to back their claims.

Key points

  • Independent review websites can help you find out more about user experience, credibility, and transparency of mental health smartphone apps.
  • As few as 2% of wellness smartphone apps have direct research studies to back their claims.
  • Increasing accessibility and improving digital privacy and data security policies are important for users.
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 figure out which apps are reliable and potentially useful?

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

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

Camacho et al., 2022
Source: Camacho et al., 2022

Given that thousands of mental health apps exist and so few of them make research-backed claims, it is important to use third-party unbiased resources to vet mental health smartphone apps.

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

One Mind PsyberGuide is a free and independent online review nonprofit website that helps shed light on the credibility, transparency, and user experience of mental health apps. Some apps are also reviewed by professionals. The guide has been written about and examined by clinicians, who found it to be comprehensive and user-friendly compared to other app review platform sites (e.g., 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 cost, privacy, clinical evidence, engagement, and clinical conditions.

Here are seven questions to examine 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 sufficient security measures? Have there been any past 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 nearly impossible for data security to be foolproof and nearly impossible to know what exactly will happen with your data or where it might end up. Nearly half of the apps shared personal health information with third parties. A recent study from 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 does not mean companies make it clear how your data could be shared or used. Consumer Reports conducted a study of seven popular mental health apps and found that some did not follow their privacy policy.

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

Both review websites will indicate whether there is clinical evidence or at least scientific foundation to support an app's claims. One Mind PsyberGuide gives apps a creditability score, which is based on research evidence of the app itself, research principles, app development, and ongoing maintenance.

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

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

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

Another consideration is whether the app allows you to delete your data once you decide that you do not 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 to multiple academic research institutions as "processing of data."

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.

7. Is the app accessible for my needs?

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

Researching mental health apps ahead of time is important, especially since sensitive private data will likely be kept in your account. These questions can help you weigh potential risks and benefits so you can decide which app is right for you.

Copyright © 2022 Marlynn Wei, MD, PLLC.

References

Camacho E, Cohen A, Torous J. Assessment of Mental Health Services Available Through Smartphone Apps. JAMA Netw Open. 2022;5(12):e2248784. doi:10.1001/jamanetworkopen.2022.48784

Goldberg SB, Lam SU, Simonsson O, Torous J, Sun S (2022) Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. PLOS Digital Health 1(1): e0000002. https://doi.org/10.1371/journal.pdig.0000002

Garland, A. F., Jenveja, A. K., & Patterson, J. E. (2021). Psyberguide: A useful resource for mental health apps in primary care and beyond. Families, Systems, & Health, 39(1), 155–157. https://doi.org/10.1037/fsh0000587

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