- New research suggests that mHealth apps designed to address mental health issues may be doing more harm than good.
In a study of some 60 popular consumer-facing mobile health apps available in the US, Canada, UK and Australia, Researchers at the University of Sydney in Australia say they oversimplify what could be a serious condition, suggesting that everyone has mental health concerns and that many of those issues could be self-managed.
"Implying mental health problems are present in everyone promotes the medicalization of normal states," Dr. Lisa Parker, a Postdoctoral Research Associate with the University of Sydney's Charles Perkins Centre and School of Pharmacy and lead author of the study, said in a press release accompanying the study, which was published in the Annals of Family Medicine.
Parker said the apps that her team studied “tended to encourage frequent use and promoted personal responsibility for improvement.” But by taking a general approach to a complex field, she said, many of them could prompt people to seek help that they don’t really need – or, in the other extreme, convince people who need medical help that they can go it alone.
"The idea that the normal ups and downs of everyday life need treatment could drive use of these apps by people with minor concerns,” Parker said. “These users are unlikely to get any significant benefits but may receive large time burdens and potential loss of privacy. … It might be useful for these people to hear alternative views about what constitutes normal psychological experiences in order to prevent overdiagnosis.”
On the other hand, Parker said, “people who have severe mental health issues may be helped by (healthcare providers) or mental healthcare workers' discussions around the limitations of app use and the importance of seeking additional forms of supportive healthcare where needed."
Funded by a research grant from the Australian Communications Consumer Action Network (ACCAN), the project analyzed how advertising for 61 popular mHealth apps portray mental health, and how they present diagnosis and treatment options. The study, conducted in late 2016, targeted apps that explicitly referenced mental health diagnoses or symptoms and offered diagnosis, guidance or made health claims.
The research goes hand-in-hand with concerns expressed by the healthcare industry that direct-to-consumer mHealth apps – which now number in the hundreds of thousands – could do more harm than good by misrepresenting health issues.
The problem isn’t limited to mental health apps. A recent study published in the journal mHealth found that women and couple seeking to prevent unwanted pregnancies are putting too much faith in fertility apps that haven’t been properly reviewed.
“Most fertility apps women reported using lack the capability for true fertility-awareness based method application for accurate, reliable pregnancy prevention,” the study, conducted by researchers from the Starling Consulting Group, Georgetown University and the University of Utah, said. “More research is needed to evaluate apps for efficacy and accuracy preventing pregnancy.”
mHealth and telehealth advocates have long called for rigorous vetting processes before mHealth apps are available to the public. And several health systems and organizations, including HIMSS and the American Medical Association, have launched programs to validate apps.
Yet while healthcare providers exercise caution in embracing and recommending mHealth apps, that isn’t necessarily keeping people from using them. They’re often easy to use and accessible from a smartphone.
"The smartphone is one of the most powerful tools for communication and apps have the potential to increase users' social supports,” Dr. Quinn Grundy, from the Charles Perkins Centre and Faculty of Pharmacy and the mental health app study’s senior author, said in the press release, “Yet popular mental health apps focus largely on individual self-help solutions and personal responsibility. This creates a great deal of silence around external and social factors related to mental health.”
"For people with serious issues, we are concerned the expectation that they can and should manage their mental health problems themselves could effectively deny the need for social supports," Grundy added.