The landscape of digital mental health apps: huge unmet needs, quality concerns, app stores asked to ensure transparency

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Address­ing the men­tal health cri­sis (Phar­ma Field):

Each day we find out more about the men­tal health effects of the pan­dem­ic. Ear­ly on, the Office for Nation­al Sta­tis­tics found that one in five Britons report­ed symp­toms of depres­sion, com­pared with one in 10 before. And, accord­ing to a recent study led by the Uni­ver­si­ty of Not­ting­ham and King’s Col­lege Lon­don, stress, anx­i­ety and depres­sion were all sig­nif­i­cant­ly high­er in par­tic­i­pants com­pared with ‘pop­u­la­tion norms’, with 64% of the par­tic­i­pants report­ing symp­toms of depres­sion and 57% report­ing symp­toms of anxiety.

… Through sim­ple force of neces­si­ty, COVID-19 has prompt­ed many peo­ple to explore the ben­e­fits of tele­health and dig­i­tal ther­a­peu­tics, from the com­fort of their home. In fact, it’s esti­mat­ed that the num­ber of peo­ple using dig­i­tal ther­a­peu­tics and well­ness apps will grow from 627 mil­lion in 2020 to more than 1.4 bil­lion in 2025. I believe that clin­i­cians and the pub­lic have realised that dig­i­tal solu­tions can deliv­er high-qual­i­ty health­care, with low­er bar­ri­ers to access, and sig­nif­i­cant ben­e­fits in cost and time effectiveness.

But there is progress to be made. Dig­i­tal men­tal health solu­tions, and the com­pa­nies that pro­vide them, must over­come some impor­tant hur­dles to ensure bet­ter user expe­ri­ence. At present, very few men­tal health apps have study data. It’s crit­i­cal that these are ground­ed in sci­ence, with activ­i­ties being evi­dence-based. For exam­ple, we use the prin­ci­ples of cog­ni­tive behav­iour­al ther­a­py (CBT), mind­ful­ness and pos­i­tive psy­chol­o­gy – all based on in-depth research. In addi­tion, eth­i­cal prac­tices must be rig­or­ous, with more being done to ensure com­pa­nies store and utilise data eth­i­cal­ly and respon­si­bly. This needs to go beyond sim­ply com­ply­ing with GDPR; dig­i­tal men­tal health com­pa­nies need to devel­op and imple­ment their own eth­i­cal frame­works and ide­al­ly have them exter­nal­ly audited.

What is the Health of Men­tal Health Apps? (ORCHA):

The Organ­i­sa­tion for the Review of Care and Health Apps (ORCHA) has reviewed almost 600 men­tal health apps that help peo­ple expe­ri­enc­ing anx­i­ety, depres­sion, self-harm, pan­ic attacks, and think­ing of sui­cide. Each app was assessed against more than 260 cri­te­ria across Clin­i­cal Assur­ance, Data Pri­va­cy, and User Experience.

Of these apps, only 29.6% meet qual­i­ty thresh­olds; a fig­ure that drops even low­er for cer­tain con­di­tions, including:

    • 27% for Addiction
    • 26% for Sui­cide Prevention
    • 23% for Insomnia
    • 18% for eat­ing disorders.
    • 9% for Bipolar
    • 5% for apps for OCD

Why Review­ing Apps Is Not Enough: Trans­paren­cy for Trust (T4T) Prin­ci­ples of Respon­si­ble Health App Mar­ket­places (Jour­nal of Med­ical Inter­net Research)

  • Abstract: The over­selling of health apps that may pro­vide lit­tle ben­e­fit and even harm needs the health community’s imme­di­ate atten­tion. With lit­tle for­mal reg­u­la­tion, a light-touch approach to con­sumer pro­tec­tion is now war­rant­ed to give cus­tomers a mod­icum of infor­ma­tion to help them choose from the vast array of so-called health apps. We sug­gest 4 guid­ing prin­ci­ples that should be adopt­ed to pro­vide the con­sumer with infor­ma­tion that can guide their choice at the point of down­load. We call these the Trans­paren­cy for Trust (T4T) prin­ci­ples, which are derived from exper­i­men­tal stud­ies, sys­tem­at­ic reviews, and reports of patient con­cerns. The T4T prin­ci­ples are (1) pri­va­cy and data secu­ri­ty, (2) devel­op­ment char­ac­ter­is­tics, (3) fea­si­bil­i­ty data, and (4) ben­e­fits. All our ques­tions are in a sim­ple form so that all con­sumers can under­stand them. We sug­gest that app stores should take respon­si­bil­i­ty for pro­vid­ing this infor­ma­tion and store it with any app mar­ket­ed as a health app. Even the absence of infor­ma­tion would pro­vide con­sumers with some under­stand­ing and fuel their choice. This would also pro­vide some com­mer­cial impe­tus for app devel­op­ers to con­sid­er this request­ed infor­ma­tion from the outset.

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