Mental health apps education on depression: Systematic assessment (Preprint)

2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Lorainne Tudor Car ◽  
Jimmy Lee ◽  
Konstadina Griva ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Guidelines ◽  
Help Seeking ◽  
Support Network ◽  
Evidence Based ◽  
Educational Content ◽  
Systematic Assessment ◽  
Android Apps ◽  
Symptoms Of Depression ◽  
Health Apps

BACKGROUND Suboptimal understanding of depression and mental health disorders by the general population is an important contributor to the wide treatment gap in depression. Mental health literacy encompasses knowledge and beliefs about mental disorders and supports their recognition, management, and prevention. Besides knowledge improvement, psychoeducational interventions reduce symptoms of depression, enhance help-seeking behavior, and decrease stigma. Mental health apps often offer educational content, but the trustworthiness of included information is unclear OBJECTIVE To systematically evaluate adherence to depression clinical guidelines of the information offered by mental health apps available in major commercial app stores. METHODS A systematic assessment of the educational content about depression in apps available in Google Play and Apple’s App Store was conducted in July 2020. A systematic search for apps published or updated since January 2019 was performed using 42matters. Apps meeting inclusion criteria were downloaded and assessed using an iPhone 7 (iOS 14.0.1) and a Sony XPERIA XZs (Android 8.0.0) smartphones. The 156 questions assessment checklist comprised general characteristics of apps, appraisal of educational content and its adherence to evidence-based clinical guidelines, and technical aspects and quality assurance. Results were tabulated and reported as a narrative review, using descriptive statistics. RESULTS The app search retrieved 2,218 apps of which 58 were included in the analysis (29 Android apps and 29 iOS apps). Thirty-seven apps (64%) offered educational content within a more comprehensive depression or mental health management app. Twelve apps (21%) provided non-evidence-based information. Most apps (51/58, 88%) included up to 20/38 educational topics assessed. Common educational topics were listing symptoms of depression (52/58, 90%) and available treatments (48/58, 83%), particularly psychotherapy. Depression-associated stigma was mentioned by 38% of apps, while suicide risk was mentioned by 71% of apps, generally as one item in a list of symptoms. Forty-four (76%) apps highlighted the importance of help-seeking, and 50% of apps emphasized the importance of involving the user’s support network. Thirty apps (52%) referenced their content and ten apps (17%) included advertisements. CONCLUSIONS Information in mental health and depression apps is often brief and incomplete. One in five apps provided non-evidence-based information. Given the unmet needs and stigma associated with the disease, it is imperative that apps seize the opportunity to offer quality, evidence-based education and/or point the users to relevant resources. A multi-stakeholder consensus on a more stringent development and publication process for mental health apps is imperative.

scholarly journals Self-guided cognitive behavioral therapy apps: Can they help? Systematic assessment of features, functionality, and congruence with evidence (Preprint)

2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Konstadina Griva ◽  
Paola Dazzan ◽  
Carmine Maria Pariante ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
Data Security ◽  
Suicide Risk ◽  
Behavioral Therapy ◽  
Cognitive Restructuring ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Systematic Assessment ◽  
Health Apps

BACKGROUND Mental health disorders affect one in ten people globally, of which around 300 million are affected by depression. At least half of affected people remain untreated. Cognitive behavioral therapy (CBT) is an effective treatment but access to specialized providers, habitually challenging, has worsened with COVID-19. Internet-based CBT (iCBT) is effective and a feasible strategy to increase access to treatment for people with depression. Mental health apps may further assist in facilitating self-management for people affected by depression but accessing the right app might be cumbersome given the large number and wide variety of apps offered by public app marketplaces. OBJECTIVE To systematically assess features, functionality, data security and congruence with evidence of self-guided CBT-based apps available in major app stores, suitable for users suffering from depression. METHODS A systematic assessment of self-guided CBT-based apps available in Google Play and Apple’s App Store was conducted. Apps launched or updated since August 2018 were identified through a systematic search in 42matters using CBT-related terms. Apps meeting inclusion criteria were downloaded and assessed using a Samsung Galaxy J7 Pro (Android 9) and iPhone 7 (iOS 13.3.1). Apps were appraised using a 182-question checklist developed by the research team, comprising apps’ general characteristics, CBT-related features, including six evidence-based CBT techniques as informed by a CBT manual, CBT competences framework and a literature review of iCBT clinical trial protocols (psychoeducation, behavioral activation, cognitive restructuring, problem solving, relaxation, and exposure for comorbid anxiety), and technical aspects and quality assurance. Results were reported as a narrative review, using descriptive statistics. RESULTS The initial search yielded 3006 apps, of which 98 apps met inclusion criteria and were systematically assessed. There were 20 wellbeing apps, 65 mental health apps and 13 depression apps. Twenty-eight apps offered at least four evidence-based CBT techniques, particularly depression apps. Cognitive restructuring was the most common technique, offered by 77/98 apps. Only a third of apps offered suicide- risk management resources while less than 20% of apps offered COVID-19-related information. Most apps included a privacy policy, but only a third of apps presented it before account creation. Eighty percent of privacy policies stated sharing data with third party service providers. Half of app development teams included academic institutions or healthcare providers. CONCLUSIONS Only few self-guided CBT-based apps offer comprehensive CBT programs or suicide risk management resources. Sharing of users’ data is widespread, highlighting shortcomings in the health app market governance. To fulfill their potential, self-guided CBT-based apps should follow evidence-based clinical guidelines, be patient-centered and enhance users’ data security. CLINICALTRIAL NA

‘Apps are cool but generally pretty pointless’: LGBTIQ+ young people’s mental health app ambivalence

2019 ◽  
Vol 171 (1) ◽  
pp. 51-65 ◽  
Author(s):  
Paul Byron
Keyword(s):  
Mental Health ◽  
Young People ◽  
Help Seeking ◽  
Social Stigma ◽  
Health Inequities ◽  
Australian Study ◽  
Health Apps ◽  
Mental Health Information ◽  
Potential Development ◽  
Health Agenda

This article considers the potential development of mental health apps for LGBTIQ+ young people. It reports on data from an Australian study of LGBTIQ+ young people’s mental health help-seeking experiences. Participants (aged 16–25 years) highlighted the potential value of mental health apps, yet also questioned the need for another digital intervention. Addressing stigma around mental health was seen as a greater priority for many, as was addressing the inadequate mental health information and support available to LGBTIQ+ young people through schools and mainstream health services. Participants noted that a mental health app must not only be useful, reliable and accessible but also actively sought, which was sometimes unlikely. This article questions a contemporary public health agenda for developing digital solutions to complex social problems. Furthermore, it asks whether health inequities and social stigma can be addressed by apps that typically prioritise the practice of individualised self-care.

scholarly journals Mobile Mental Health Apps in China: Systematic App Store Search (Preprint)

2019 ◽  
Author(s):  
Huifang Yin ◽  
Klaas J Wardenaar ◽  
Yuhao Wang ◽  
Nan Wang ◽  
Wenjin Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Mobile Apps ◽  
Psychiatric Patients ◽  
Evidence Based ◽  
Health Apps ◽  
Main Technique ◽  
Stress Relieving ◽  
Mobile Mental Health

BACKGROUND Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. OBJECTIVE The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. METHODS A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. RESULTS Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. CONCLUSIONS Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

scholarly journals Mobile Mental Health Apps in China: Systematic App Store Search

10.2196/14915 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e14915
Author(s):  
Huifang Yin ◽  
Klaas J Wardenaar ◽  
Yuhao Wang ◽  
Nan Wang ◽  
Wenjin Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Mobile Apps ◽  
Psychiatric Patients ◽  
Evidence Based ◽  
Health Apps ◽  
Main Technique ◽  
Stress Relieving ◽  
Mobile Mental Health

Background Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. Objective The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. Methods A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. Results Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. Conclusions Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

scholarly journals Suicide prevention and depression apps’ suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Laura Martinengo ◽  
Louise Van Galen ◽  
Elaine Lum ◽  
Martin Kowalski ◽  
Mythily Subramaniam ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Clinical Guidelines ◽  
Suicide Attempts ◽  
Mobile Apps ◽  
Suicidal Thought ◽  
Direct Access ◽  
Evidence Based ◽  
Prevention Strategies ◽  
Systematic Assessment ◽  
Depression Management

Abstract Background There are an estimated 800,000 suicides per year globally, and approximately 16,000,000 suicide attempts. Mobile apps may help address the unmet needs of people at risk. We assessed adherence of suicide prevention advice in depression management and suicide prevention apps to six evidence-based clinical guideline recommendations: mood and suicidal thought tracking, safety plan development, recommendation of activities to deter suicidal thoughts, information and education, access to support networks, and access to emergency counseling. Methods A systematic assessment of depression and suicide prevention apps available in Google Play and Apple’s App Store was conducted. Apps were identified by searching 42matters in January 2019 for apps launched or updated since January 2017 using the terms “depression,” “depressed,” “depress,” “mood disorders,” “suicide,” and “self-harm.” General characteristics of apps, adherence with six suicide prevention strategies identified in evidence-based clinical guidelines using a 50-question checklist developed by the study team, and trustworthiness of the app based on HONcode principles were appraised and reported as a narrative review, using descriptive statistics. Results The initial search yielded 2690 potentially relevant apps. Sixty-nine apps met inclusion criteria and were systematically assessed. There were 20 depression management apps (29%), 3 (4%) depression management and suicide prevention apps, and 46 (67%) suicide prevention apps. Eight (12%) depression management apps were chatbots. Only 5/69 apps (7%) incorporated all six suicide prevention strategies. Six apps (6/69, 9%), including two apps available in both app stores and downloaded more than one million times each, provided an erroneous crisis helpline number. Most apps included emergency contact information (65/69 apps, 94%) and direct access to a crisis helpline through the app (46/69 apps, 67%). Conclusions Non-existent or inaccurate suicide crisis helpline phone numbers were provided by mental health apps downloaded more than 2 million times. Only five out of 69 depression and suicide prevention apps offered all six evidence-based suicide prevention strategies. This demonstrates a failure of Apple and Google app stores, and the health app industry in self-governance, and quality and safety assurance. Governance levels should be stratified by the risks and benefits to users of the app, such as when suicide prevention advice is provided.

scholarly journals Digital health developments and drawbacks: a review and analysis of top-returned apps for bipolar disorder

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Sarah Lagan ◽  
Abinaya Ramakrishnan ◽  
Evan Lamont ◽  
Aparna Ramakrishnan ◽  
Mark Frye ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Evaluation System ◽  
Comprehensive Evaluation ◽  
Mobile Apps ◽  
Digital Health ◽  
Unmet Need ◽  
Evidence Based ◽  
Mood Management ◽  
Health Apps

Abstract Background Although a growing body of literature highlights the potential benefit of smartphone-based mobile apps to aid in self-management and treatment of bipolar disorder, it is unclear whether such evidence-based apps are readily available and accessible to a user of the app store. Results Using our systematic framework for the evaluation of mental health apps, we analyzed the accessibility, privacy, clinical foundation, features, and interoperability of the top-returned 100 apps for bipolar disorder. Only 56% of the apps mentioned bipolar disorder specifically in their title, description, or content. Only one app’s efficacy was supported in a peer-reviewed study, and 32 apps lacked privacy policies. The most common features provided were mood tracking, journaling, and psychoeducation. Conclusions Our analysis reveals substantial limitations in the current digital environment for individuals seeking an evidence-based, clinically usable app for bipolar disorder. Although there have been academic advances in development of digital interventions for bipolar disorder, this work has yet to be translated to the publicly available app marketplace. This unmet need of digital mood management underscores the need for a comprehensive evaluation system of mental health apps, which we have endeavored to provide through our framework and accompanying database (apps.digitalpsych.org).

scholarly journals A Multimodal Intervention for Improving the Mental Health and Emotional Well-being of College Students

2017 ◽  
Vol 14 (2) ◽  
pp. 216-224 ◽  
Author(s):  
Darren P. Morton ◽  
Jason Hinze ◽  
Bevan Craig ◽  
Wendi Herman ◽  
Lillian Kent ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Positive Psychology ◽  
Well Being ◽  
Evidence Based ◽  
Lifestyle Medicine ◽  
Multimodal Intervention ◽  
Symptoms Of Depression ◽  
Psychology Literature ◽  
The Individual

This study examined the effectiveness of a 10-week multimodal intervention for improving the mental health and emotional well-being of college students when included as a mandatory component of the students’ course of study. A total of 67 students (20.9 ± 5.4 years, 30 male/37 female) participated in the intervention that introduced a variety of evidence-based strategies for improving mental health and emotional well-being from the Lifestyle Medicine and Positive Psychology literature. Significant reductions were recorded in symptoms of depression (−28%, P < .05), anxiety (−31%, P < .05), and stress (−28%, P < .01), whereas significant improvements were observed in mental health (18%, P < .01), vitality (14%, P < .01) and overall life satisfaction (8%, P < .05). Effect sizes were larger than those reported by studies that have examined the individual effectiveness of the strategies incorporated into the intervention, suggesting a compounding effect. Stratified analyses indicated that participants with the lowest measures of mental health and emotional well-being at baseline experienced the greatest benefits. The findings of the study suggest that meaningful improvements in the mental health and emotional well-being of college students can be achieved, and potentially magnified, by utilizing a multidisciplinary approach involving evidence-based strategies from Lifestyle Medicine and Positive Psychology.

scholarly journals An Assessment Framework for e-Mental Health Apps in Canada: Results of a Modified Delphi Process (Preprint)

2018 ◽  
Author(s):  
Jennifer Zelmer ◽  
Krystle van Hoof ◽  
MaryAnn Notarianni ◽  
Trevor van Mierlo ◽  
Megan Schellenberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Delphi Process ◽  
Security And Privacy ◽  
Rapid Review ◽  
Evidence Based ◽  
Assessment Framework ◽  
Health Apps ◽  
Modified Delphi ◽  
Mapping Process ◽  
Guiding Principles

BACKGROUND The number of e-mental health apps is increasing rapidly. Studies have shown that the use of some apps is beneficial, whereas others are ineffective or do not meet users’ privacy expectations. Individuals and organizations that curate, recommend, host, use, or pay for apps have an interest in categorizing apps according to the consensus criteria of usability and effectiveness. Others have previously published recommendations for assessing health-related apps; however, the extent to which these recommendations can be generalized across different population groups (eg, culture, gender, and language) remains unclear. This study describes an attempt by Canadian stakeholders to develop an e-mental health assessment framework that responds to the unique needs of people living in Canada in an evidence-based manner. OBJECTIVE The objective of our study was to achieve consensus from a broad group of Canadian stakeholders on guiding principles and criteria for a framework to assess e-mental health apps in Canada. METHODS We developed an initial set of guiding principles and criteria from a rapid review and environmental scan of pre-existing app assessment frameworks. The initial list was refined through a two-round modified Delphi process. Participants (N=25) included app developers and users, health care providers, mental health advocates, people with lived experience of a mental health problem or mental illness, policy makers, and researchers. Consensus on each guideline or criterion was defined a priori as at least 70% agreement. The first round of voting was conducted electronically. Prior to Round 2 voting, in-person presentations from experts and a persona empathy mapping process were used to explore the perspectives of diverse stakeholders. RESULTS Of all respondents, 68% (17/25) in Round 1 and 100% (13/13) in Round 2 agreed that a framework for evaluating health apps is needed to help Canadian consumers identify high-quality apps. Consensus was reached on 9 guiding principles: evidence based, gender responsive, culturally appropriate, user centered, risk based, internationally aligned, enabling innovation, transparent and fair, and based on ethical norms. In addition, 15 informative and evaluative criteria were defined to assess the effectiveness, functionality, clinical applicability, interoperability, usability, transparency regarding security and privacy, security or privacy standards, supported platforms, targeted users, developers’ transparency, funding transparency, price, user desirability, user inclusion, and meaningful inclusion of a diverse range of communities. CONCLUSIONS Canadian mental health stakeholders reached the consensus on a framework of 9 guiding principles and 15 criteria important in assessing e-mental health apps. What differentiates the Canadian framework from other scales is explicit attention to user inclusion at all stages of the development, gender responsiveness, and cultural appropriateness. Furthermore, an empathy mapping process markedly influenced the development of the framework. This framework may be used to inform future mental health policies and programs.

scholarly journals Popular Evidence-Based Commercial Mental Health Apps: Analysis of Engagement, Functionality, Aesthetics, and Information Quality

10.2196/29689 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e29689
Author(s):  
Nancy Lau ◽  
Alison O'Daffer ◽  
Joyce P Yi-Frazier ◽  
Abby R Rosenberg
Keyword(s):  
Mental Health ◽  
Information Quality ◽  
Evidence Based ◽  
User Centered Design ◽  
Design Elements ◽  
Evidence Based Treatment ◽  
Health Apps ◽  
Consumer Ratings ◽  
App Design ◽  
User Ratings

Background There is a robust market for mobile health (mHealth) apps focused on self-guided interventions to address a high prevalence of mental health disorders and behavioral health needs in the general population. Disseminating mental health interventions via mHealth technologies may help overcome barriers in access to care and has broad consumer appeal. However, development and testing of mental health apps in formal research settings are limited and far outpaced by everyday consumer use. In addition to prioritizing efficacy and effectiveness testing, researchers should examine and test app design elements that impact the user experience, increase engagement, and lead to sustained use over time. Objective The aim of this study was to evaluate the objective and subjective quality of apps that are successful across both research and consumer sectors, and the relationships between objective app quality, subjective user ratings, and evidence-based behavior change techniques. This will help inform user-centered design considerations for mHealth researchers to maximize design elements and features associated with consumer appeal, engagement, and sustainability. Methods We conducted a user-centered design analysis of popular consumer apps with scientific backing utilizing the well-validated Mobile Application Rating Scale (MARS). Popular consumer apps with research support were identified via a systematic search of the App Store iOS (Apple Inc) and Google Play (Google LLC) and literature review. We evaluated the quality metrics of 19 mental health apps along 4 MARS subscales, namely, Engagement, Functionality, Aesthetics, and Information Quality. MARS total and subscale scores range from 1 to 5, with higher scores representing better quality. We then extracted user ratings from app download platforms and coded apps for evidence-based treatment components. We calculated Pearson correlation coefficients to identify associations between MARS scores, App Store iOS/Google Play consumer ratings, and number of evidence-based treatment components. Results The mean MARS score was 3.52 (SD 0.71), consumer rating was 4.22 (SD 0.54), and number of evidence-based treatment components was 2.32 (SD 1.42). Consumer ratings were significantly correlated with the MARS Functionality subscale (r=0.74, P<.001), Aesthetics subscale (r=0.70, P<.01), and total score (r=0.58, P=.01). Number of evidence-based intervention components was not associated with MARS scores (r=0.085, P=.73) or consumer ratings (r=–0.329, P=.16). Conclusions In our analysis of popular research-supported consumer apps, objective app quality and subjective consumer ratings were generally high. App functionality and aesthetics were highly consistent with consumer appeal, whereas evidence-based components were not. In addition to designing treatments that work, we recommend that researchers prioritize aspects of app design that impact the user experience for engagement and sustainability (eg, ease of use, navigation, visual appeal). This will help translate evidence-based interventions to the competitive consumer app market, thus bridging the gap between research development and real-world implementation.

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