02 Jan How Should Mental Health Apps be Evaluated and Endorsed?
Good mental health is the buzz in this post-pandemic world. Everywhere you turn, there is evidence of the focus on mental health. In June of 2022, the Federal government passed legislation that would reauthorize and expand behavioral health programs. Technology allows people to access mental health care in a way never done before. Thousands of apps are available to help manage sleep, stress, and anxiety. While no app can substitute the benefits of therapy with a licensed professional, these resources can supplement them and offer additional resources for people struggling with adverse mental health symptoms.
With so much attention, the development of mental health apps is booming. Currently, an estimated 20,000 mental health apps are on the market, growing 32% between 2019 and 2020.
With so much growth, however, how can consumers ensure that the app they choose to help manage their mental health is trustworthy and reliable? The quality of these apps should be of significant concern for mental health professionals. Therapists and psychologists act as a guide for their clients in how they learn to manage their emotional wellness. Thus, the use of apps should be a conversation for all professionals with the individuals they are working with.
Likely many of these apps are harmless and offer some support to users; however, many have no empirical evidence supporting their efficacy. Additionally, they may have been developed without the involvement of mental health professionals on the design team. Individuals may utilize an app that provides minimal benefit and while this is a waste of time, there are potentially dangerous side effects. A person seeking help with managing what might be life-threatening symptoms of a mental illness needs help right away. An app designed without any disclaimers about when and how to seek help in a crisis may be detrimental. Additionally, an app the offers minimal help might further exacerbate symptoms of hopelessness that accompany depression, resulting in a person feeling that there is not help for them.
The importance of treating mental health with quality care calls for some means of evaluating and endorsing apps designed for behavioral health. Currently, the FDA encourages the development of mobile medical apps such as those for emotional wellness. The FDA, therefore, asserts the public health responsibility to oversee the safety and effectiveness of such apps. This assertion, however, does not assure that all apps on the market are evaluated and endorsed by the FDA. Presently, only the apps that promote themselves as devices for medical treatment. So, if an app offers only education about mental health, it is not required to seek FDA approval. However, if an app delivers a therapeutic intervention, the developers could seek FDA approval to certify their app. There is no regulation, however that requires this—leaving the consumer at risk of not knowing if the app they have chosen for themselves is evidence-based or created by a licensed professional.
The American Psychological Association (APA) has published an App Evaluation Model designed to help practitioners evaluate an app’s validity and safety based on a framework model. There remains the caveat that not app approaches work for all people, so an app with a CBT foundation might not be the best fit for all. This App Evaluation Model aims to gather information on the following:
- Where is it from? This is the basic information about the app, such as who made it, the cost, and the foundational model.
- Is it safe? The App Evaluation Model requires the practitioner to examine if the app collects personal data and personal health information, does it sell personal data to a third party, and whether it is HIPAA compliant.
- Is it useful? App developers want to sell their product and use gimmicky language, suggesting that it is based on evidence-based practices. However, this does not mean it adheres to an evidence-based model. Practitioners need to examine if the app is supported by empirical research. The likelihood that many apps have been scientifically tested is rare. Therefore, consumers should look at apps developed by licensed professionals and endorsed by experts in the field.
- Is it usable? Many apps hold attention for a few days or weeks, then lose their novelty. An app should be easy to use, offer good reminders, and valuable resources to ensure that it is beneficial and usable for the long haul. It should have the option for use on a mobile device to help support ease of access.
- Is it integrated? Some apps will integrate into an electronic medical record. This is optimal for individuals linked with a mental health professional.
Access to healthcare in the digital world is moving at the speed of light. Currently, there is no standard by which apps claiming to offer help for people needing emotional support are evaluated for safety and efficacy. Professionals in the field must advocate that mental health apps are evaluated and endorsed to help ensure that this new means of accessing behavioral healthcare is safe.