Research Technology — 10 May 2017

Downloading an app seemed like the simplest way to cope with the stress and anxiety Jazmin was experiencing.

“You could go to the app store and download it and it would be on your phone in five minutes rather than having to go and make an appointment with a professional,” the 27-year-old says.

Apps have the right idea but do they work? Photo: Stocksy

Apps have the right idea but do they work? Photo: Stocksy

The anonymity and the fact that she didn’t have to share added to the appeal of an app.

With nearly 90 per cent of young Australians using smartphones and a similar percentage downloading from the 2 billion plus apps on the market, mental health apps have been tipped as the future of treating mental health for many.

Apps, of which more than 100,000 health-specific are available, have also been seen as an accessible means of service to those in rural or remote communities, where rates of self-harm and suicide are high.

But, new research by the University of Sydney has cautioned Australians over using them.

Until now, no one has analysed the mental health apps on the market.

“So we put together a team of researchers to look at a sample of one of the most booming parts of the app market, which is mental health,” says lead researcher Dr Quinn Grundy, a postdoctoral research fellow at the Charles Perkins Centre. 

“And not only are mental health apps among the apps that have the highest downloads and revenues but government and particularly the Australian government are prioritising use of mental health apps in mental health services.”

Grundy and her team, who partnered with the Australian Communications Consumer Action Network (ACCAN), analysed 61 of the “top” apps available on the market – apps that are either the most popular in-store or endorsed by governments or major health organisations or mental health groups .

They were hoping to produce a list of apps they could advocate to the public.

“But we, in good conscience at the end of the day, didn’t feel like we could endorse any of the apps,” Grundy says.

“If some of them had good evidence and had been made by clinicians or researchers… they would often lack basic privacy assurances. It’s not to say that they are selling your data but there’s no way to ensure that that’s not the case. Consumers weren’t told what personal data was being collected, not told whether and with whom it might be shared and – especially in a global market – if your data is going overseas.”

She adds that there was also “really no way” for a consumer to make a complaint if they felt their privacy had been violated.

It was not only the issue of privacy that caught the researchers’ attention.

“The apps tend to make promises like your mental health will be improved rapidly and easily without any effort – so it will say ‘better sleep in just 10 minutes’ or ‘find relaxation through these breathing exercises’ or ‘just a little mindfulness and you’ll have success at work and in your relationships’,” Grundy says.

They were also “surprised” at how many apps claimed they could “treat the entire spectrum”, from mild distress to depression to PTSD. 

“Our concern is that focus is on individual and it also sends the message that you’re responsible for dealing with your own stress or anxiety or depression. And then if that app doesn’t work for you, are you left in a position of feeling like your problem is too severe or you’ve failed again. I think it’s possible that these tools could be really helpful and supportive but they can also send messages that you’re sick or that it’s your fault or that nothing can be done for you.”

Jazmin stopped using the free app she downloaded after three months.

“In the beginning, like anything new and shiny, it was exciting,” says the PhD student. “It got you to log what you did during the day and how it made you feel.” 

She says she didn’t mind the tracking process initially.

“But, you have off days where you just want to eat junk food – so you could look back and it looked like you’d had a really bumpy road even when you felt like you were getting better and I found that contradictory. And if I was having a bad day, reviewing the day compounded my negative feelings.”

Although she found the guided relaxation audios soothing, they were no longer free as you “progressed” and “in terms of support, there wasn’t any given”, she says. 

“There were some forums you could post on but some of the posts were actually pretty depressing so I didn’t go on them very often,” Jazmin says. “The guided relaxation was OK for me, but in terms of support I don’t think it really gave me anything.”

She says that, if she was to advise a friend going through anything similar, she would suggest they seek face-to-face counselling.

“I think there would be more benefit from getting tailored support.”

On Tuesday, experts gathered at the University of Sydney to discuss mental health apps moving forward.

The topic of the discussion, “Finding peace of mind: Ensuring integrity and countering bias in mental health apps” will explore the issues and what mechanisms can be implemented to ensure consumers get safe and quality apps.

In the meantime, Grundy says they have tips for consumers: 

  • “Go for paid apps, so pay those couple of dollars upfront… if you pay upfront it’s less likely that your data is going to be sold to advertisers or sold for other purposes.”
  • “Choose an app from someone you trust. There’s a lot of individuals – people and companies – that are well-intentioned and have made a mental health app because they want to help people or they’ve had experience themselves but they’re not necessarily coming from a place where that content is evidence-based or from a public health perspectives.”
  • “Especially on android apps there’s a way to check – they’re called permissions – the kind of data that the app is asking from you, so you want to check those.

This piece by Sarah Berry was first seen on ‘The Sydney Morning Herald‘ May 9 2017.

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