Much like picking a cereal brand from a myriad of options, the booming mental health app market presents wide-ranging alternatives. Affordable and easily accessible, these apps promise to alleviate the pressure faced by the overtaxed NHS mental health services. They offer the benefit of self-managed mental health care to those who need it.
However, concerns about the efficacy and regulation of these apps are on the rise. Doubts surrounding their potential harm and their proclaimed benefits are mushrooming.
Yet, data to support these concerns or refute them remains sparse.
Irrespective of the caveats, it is generally believed that these apps, although deficient in their ability to promote optimal mental well-being, are unlikely to harm mental health. Dodging regulatory responsibilities, these apps often brand themselves as wellness tools than therapeutic ones. They avoid dispensing regulated advice but can guide users towards more substantial help. This manoeuvre also relieves them from monitoring critical alerts such as self-harm threats from users.
Distinct from conventional therapy, these apps are built for quick, sporadic use as per user convenience.
The diversity of mental health apps is overwhelming, with app stores brimming with various offerings tailored to differing needs and levels of support. However, a significant downside is the lack of comprehensive proof of their efficiency. Rating metrics lack controlled trials and in-depth scrutiny, and app stores fail to furnish this data pre-download.
This opacity leaves users in the dark about the app’s utility and might even deter them from opting for proven therapeutic care.
Effective mental health interventions should be evidence-based and facilitate prolonged user engagement. But, these apps, although easily downloadable, are equally easy to disregard. Numerous instances cite app-based interventions that recorded scanty interaction post-download or faced swift user engagement decline.
These apps, it seems, are more than just a short-lived trend. The National Institute for Care and Excellence (Nice) sanctioned eight online interventions in March 2023. This move towards digital therapies, I believe, can supplement additional support to those who need it. They can serve as a useful adjunct to conventional therapeutic sessions.
Crucially, the sanctioned eight apps will undergo scientific appraisal, potentially paving the way for the remaining market.
For mental health apps, utmost transparency is needed. Users must know what they are getting, steering clear of any misrepresentations.
Back in 2019, Stephen Schueller and I proposed four principles for mental health apps aimed at full transparency: understanding personal data collection and usage, involvement of target users in app designing, prescribed usage quantity, and assurance of safety, and measurable benefits derived from the app.
My stance in 2019 was that formality of regulation isn’t vital. False advertising on apps can be reported to advertising standards bodies, and regulated standards govern actual therapy provision. Seeking the right therapist requires due diligence from the seeker.
My view on regulation remains unchanged, although it doesn’t rule out the need for modifications. “Libertarian havens” like Google Play or Apple’s App Store should instate guidelines for marketing health apps.
Establishing strict criteria for “health” apps and implementing a clear rule-set like ours can enhance users’ faith that their downloaded app can help them. Thus, users should be capable of choosing their mental health app with the same ease of picking cereal.
