Mental Health Apps: How Medicine Can Keep Up With Tech

Thanks to Dashlane for sponsoring this episode.
Go to to learn more about Dashlane. [ ♪INTRO ] Silicon Valley thinks they have a solution
for everything. Including, apparently, the fact that not everyone around the world who
needs mental health care gets it. And at this very moment, there are thousands
of mental health apps out there claiming to do everything from easing insomnia to treating
PTSD symptoms. But as you might expect, many of the apps
out there aren’t backed by evidence. But mental health experts are hoping to change
that. In theory, getting therapy over the internet
can be effective. After all, research suggests a given treatment’s
effectiveness comes down less to the specifics of how it’s administered than it does to
the relationship a patient has with their therapist. If that therapist is over the internet, it
might not make much of a difference. Studies lend some support to the idea that
getting cognitive behavioral therapy, or CBT, online with a real clinician is effective.
And experts say CBT is one of the best evidence-based tools we have. A 2014 meta-analysis found that guided online
CBT — that is, with guidance from a therapist, whether via email or real-time chat — produced
similar effects to face-to-face therapy. But for some patients, therapist guidance
may not even be necessary. A 2017 meta-analysis found that a self-guided
form of online CBT may be a good first step in treating symptoms of depression, especially
for people who are unwilling to work with a therapist. But not all online programs are created equal.
There are far more apps out there than there is research that’s been done on them. A review in 2013 tallied more than 3,000 available
mental health apps but found only 8 studies and those involving only 5 of those 3,000
apps. But even when there is research, it’s not
exactly airtight. For one thing, most studies have been designed to determine whether a
treatment (or intervention, as it’s often called) is practical, not necessarily effective. Hardly any are placebo-controlled, and the
few randomized trials out there tend to be small and don’t end up being replicated.
Plus, most of the studies are done by the app developers themselves instead of independent
researchers. And that’s just studies in high-income countries.
The research situation in low- and middle-income countries is even worse. And when a mental health app is bad, it can
be really bad. Some contain information so wrong that it’s harmful. In a 2015 review of apps for bipolar disorder,
researchers noted that one app recommended taking a shot of liquor to help users sleep
during a manic episode. Another said that bipolar disorder can spread
to your loved ones if they spend too much time listening to your problems. Just in case we have to specify: NO. BAD.
NOT TRUE. And of course, there are also the privacy
concerns. Those are scary enough when you’re downloading a game app to pass the time, but
it’s way worse when you’re using an app to share sensitive health information. Researchers have voiced concerns about the
fact that patient data from these apps might be sold and used in algorithms that automatically
classify people in ways that can affect their credit, employment, and education. But that’s not to say mental health apps
are worthless. There are some success stories out there. Take the app PTSD Coach, for instance. It was developed through a partnership between
the U.S. Department of Veterans Affairs and the U.S. Department of Defense as a way to
help military veterans with mild to moderate symptoms of PTSD. The app provides information about PTSD, helps
users track their symptoms, supplies referrals for crisis support, and offers CBT-based coping
tools for times of distress. A preliminary evaluation in 2014 and two randomized
controlled trials in 2016 found the app to be an acceptable intervention — though,
as with many apps like it, the researchers say they’ll need a larger trial to confirm
its effectiveness. But PTSD coach has another problem. It looks
awful. Clinical psychologists aren’t graphic designers, and they’re not exactly on the
bleeding edge of user interface design. That’s an issue with apps backed by research.
Technology moves fast, and studies take time. Once an evidence-based app is ready to hit
the app store, it looks out of date next to all the sleek, cutting-edge programs full
of information that you can’t necessarily trust. In general, experts note that online and app-based
mental-health interventions have a lot of potential. However, they’ve called for more research
into the effectiveness and long-term effects of these apps — as well as ways to manage
privacy and security concerns. But as far as identifying which apps are worth
downloading, there are some trustworthy resources out there. The American Psychiatric Association has developed
a model it uses to judge mental health apps in four main areas: level of evidence, privacy
and security, ease of use, and interoperability, which is the ability to share the data with
your healthcare team. Other associations also review and rate mental
health apps on their evidence. The Anxiety and Depression Association of America lists
19 different apps on their website, for example. Mental health apps aren’t perfect, but once
they’ve been properly tested, they could be a saving grace for people who don’t otherwise
have access to the services they need. More research and more vetting from trusted
sources are still needed for them to reach that point, though. One thing’s for sure:
You can’t believe everything you read on the app store. Earlier in this episode, we talked about how
privacy is a major concern when it comes to mental health apps. But really, privacy is
worth thinking about whenever you’re on the Internet. And if you want to learn more
about staying protected, you can check out Dashlane. Dashlane Premium not only has Dark Web Monitoring
and a secure VPN, but it also allows you to save and autofill personal information like
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forms with just a single click. It’s a good way to streamline your life! If you want to learn more or check out Dashlane
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for ten percent off Dashlane Premium. [ ♪OUTRO ]