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Since more than 50% of people worldwide can’t access appropriate mental health treatments, let’s welcome (and test) mobile health apps

mobilehealthMen­tal Health: There’s an App for That (Nature):

Type ‘depres­sion’ into the Apple App Store and a list of at least a hun­dred pro­grams will pop up on the screen. There are apps that diag­nose depres­sion (Depres­sion Test), track moods (Opti­mism) and help peo­ple to “think more pos­i­tive” (Affir­ma­tions!). There’s Depres­sion Cure Hyp­no­sis (“The #1 Depres­sion Cure Hyp­no­sis App in the App Store”), Grat­i­tude Jour­nal (“the eas­i­est and most effec­tive way to rewire your brain in just five min­utes a day”), and dozens more. And that’s just for depres­sion. There are apps pitched at peo­ple strug­gling with anx­i­ety, schiz­o­phre­nia, post-trau­mat­ic stress dis­or­der (PTSD), eat­ing dis­or­ders and addic­tion.

This bur­geon­ing indus­try may meet an impor­tant need. Esti­mates sug­gest that about 29% of peo­ple will expe­ri­ence a men­tal dis­or­der in their life­time. Data from the World Health Orga­ni­za­tion (WHO) show that many of those peo­ple — up to 55% in devel­oped coun­tries and 85% in devel­op­ing ones — are not get­ting the treat­ment they need…But the tech­nol­o­gy is mov­ing a lot faster than the science…But the bare fact is that most apps haven’t been test­ed at all. A 2013 review (note: see below) iden­ti­fied more than 1,500 depres­sion-relat­ed apps in com­mer­cial app stores but just 32 pub­lished research papers on the sub­ject…

To make good on that promise, apps will have to be test­ed. Between 2013 and 2015, the num­ber of mobile-health tri­als reg­is­tered on ClinicalTrials.gov more than dou­bled, from 135 to 300. And the num­ber of tri­als specif­i­cal­ly focused on men­tal and behav­iour­al health increased by 32%, accord­ing to a report by the IMS Insti­tute for Health Infor­mat­ics in Par­sip­pa­ny, New Jer­sey.”

Study: Smart­phones for Smarter Deliv­ery of Men­tal Health Pro­grams: A Sys­tem­at­ic Review (Jour­nal of Med­ical Inter­net Research). From the abstract:

  • Back­ground: The rapid growth in the use of mobile phone appli­ca­tions (apps) pro­vides the oppor­tu­ni­ty to increase access to evi­dence-based men­tal health care.
  • Objec­tive: Our goal was to sys­tem­at­i­cal­ly review the research evi­dence sup­port­ing the effi­ca­cy of men­tal health apps for mobile devices (such as smart­phones and tablets) for all ages.
  • Meth­ods: A com­pre­hen­sive lit­er­a­ture search (2008–2013)…We includ­ed tri­als that exam­ined the effects of men­tal health apps (for depres­sion, anx­i­ety, sub­stance use, sleep dis­tur­bances, sui­ci­dal behav­ior, self-harm, psy­chot­ic dis­or­ders, eat­ing dis­or­ders, stress, and gam­bling) deliv­ered on mobile devices with a pre- to posttest design or com­pared with a con­trol group. The con­trol group could con­sist of wait list, treat­ment-as-usu­al, or anoth­er rec­og­nized treat­ment.
  • Results: In total, 5464 abstracts were iden­ti­fied. Of those, 8 papers describ­ing 5 apps tar­get­ing depres­sion, anx­i­ety, and sub­stance abuse met the inclu­sion cri­te­ria…
  • Con­clu­sions: Men­tal health apps have the poten­tial to be effec­tive and may sig­nif­i­cant­ly improve treat­ment acces­si­bil­i­ty. How­ev­er, the major­i­ty of apps that are cur­rent­ly avail­able lack sci­en­tif­ic evi­dence about their effi­ca­cy. The pub­lic needs to be edu­cat­ed on how to iden­ti­fy the few evi­dence-based men­tal health apps avail­able in the pub­lic domain to date. Fur­ther rig­or­ous research is required to devel­op and test evi­dence-based pro­grams…

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