Do Mental Health Apps Work?

One in five American adults will experience mental illness, according to the National Alliance on Mental Illness. But, only a fraction of those people get the help that they need. Could therapy apps be the answer?

Many companies seem to think so. There are thousands of apps available on both Android and IOS devices that claim to:

• improve mood
• reduce anxiety and stress using Cognitive Behavior Therapy (CBT)
• help manage chronic conditions such as bi-polar disorder or Alzheimer’s disease
• track daily behavior and “ping” users to perform “mood checks”

Just about anyone can create an app. How do you know if a software application will help? And what about your privacy?

With so many apps on the market, few of which are thoroughly tested, choosing one that’s right for you is not easy.

Here are a few things to keep in mind.

Technology has limits.

Software applications make it easier to access mental health guidance if you don’t have the time, finances or desire to see a therapist in person. Based on their review of scientific literature, Dr. Luca Pani and Philip Harvey, Ph.D., research psychiatrists with the University of Miami Health System, believe that apps providing Computerized Cognitive Behavior Therapy/Training (CCBT) are beneficial.

But, before you click “install”, consider their cautionary advice.

“Apps are not a substitute for psychological or medical intervention. Apple’s disclaimer states this. However, when used in combination with a professional therapist, mental health apps show great promise,” says Dr. Pani.

Dr. Harvey agrees, adding this caveat: “The best use for apps is self-monitoring between sessions with a mental health professional – whether you’re using talk therapy or pharmaceuticals.”

Most importantly, the time not to use mental health apps is if you – or a loved one is – in crisis or thinking about suicide. Instead, call the 24/7 Suicide Prevention Hotline at 1-800-273-8255.  All calls are confidential and free.

Licensed mental health professionals are legally required to protect your privacy.

What you share stays with them. Before using an app, Dr. Pani suggests reading the developer’s privacy policy. To find out how the FDA is regulating software developers, he recommends reading their Digital Health Innovation Action Plan. “The field is in its infancy. In the last 24 months, the FDA started a certification program to qualify and approve apps.”

Dr. Harvey says that PsyberGuide.org is a good resource for vetting apps. Developed by a not-for-profit brain research organization, it rates the privacy, credibility and user experience of nearly 200 apps.

While the doctors acknowledge there are challenges with mental health apps, they are hopeful about technology’s potential to improve lives.

In the highly complex realm of brain science, there is no such thing as one-size-fits-all.

“It is difficult to determine if an app is diagnostically specific for a wide range of disorders, such as schizophrenia, depression and Alzheimer’s disease. These disorders bear different neurobiological mechanisms and are treated with vastly different pharmacological interventions. Not every app is effective for all people,” says Dr. Harvey.

However, apps are a good first step, especially if you’re reluctant to ask for help.

“You can start by self-monitoring to see if you actually need to see a therapist. Some apps signal you to seek help if your mood starts to interfere with daily activities,” says Dr. Harvey.

Apps also bridge the gap for people living in low-income or rural areas. Their portability and interactive, on-demand design gives users access to help when they’re in distress, instead of waiting until their next counseling session.

The Food and Drug Administration (FDA) has approved reSET, an app that uses CBT to help treat substance abuse. After studying hundreds of patients during a 12-week, multi-site clinical trial, software developers showed that patients using reSET significantly increased their abstinence.

Technology in action at UHealth

Self-administered cognitive and mental health skills training can help people improve their memory, concentration, attention, and mental speed.

“If you have major depression, bi-polar disorder, schizophrenia or any psychotic disorder, you can have residual cognitive impairment even after your mood improves,” Dr. Harvey says.

Computer-based cognitive training helps people recognize impairment and refine their cognitive skills. People can join training sessions at UHealth’s Brain Fitness Pavilion. The facility was the first of its kind in South Florida. It was designed not only for those with cognitive disorders, but for older people who want to stay mentally sharp.

In November 2018, the University of Miami Counseling Center began offering WellTrack, an interactive self-help and therapy app that helps students manage anxiety and depression.

“Today’s students expect to receive mental health services.”

“Nationwide, 30% are on medication for mental health issues when they come to counseling centers. Our students have been asking for something like WellTrack,” says Rene Monteagudo, Ph.D., director of the Counseling Center. “Given the increase in mental health issues and the increased pressure on counseling centers, we need to provide as many resources as possible.”

Dr. Monteagudo enlisted student volunteers to help evaluate the app. “The students really resonated with WellTrack. It is straightforward, personalized, self-paced and based on science.”

Prior to use, students complete a self-assessment. Within the first year, more than 850 of the kids used the app.

“According to WellTrack data reports, 73% got better,” says Dr. Monteagudo. About 90% have not come into the counseling center for therapy, but that is not necessarily the goal. “We try to meet students where they’re at. The app is a good starting point for students with anxiety and depression that is bothersome, but not overwhelming. It also helps those afraid to come into the center and those who’ve gone through counseling and need a booster. I don’t see it as a replacement for traditional talk therapy, but as an additional tool in their toolbox.”

WellTrack is HIPPA-compliant and underwent rigorous security verifications by the University’s IT department, says Dr. Monteagudo. “Students control their data. I’m confident in its security.”

Nancy Moreland is a regular contributor to UMiami Health News.  She has written for several major health care systems and the Centers for Disease Control and Prevention. Her writing also appears in the Chicago Tribune.

Tags: anxiety, depression, mental health, mental health apps, mental health counseling, mental illness