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Analyzing the effectiveness of mental health apps in a world where we need to take a break
Mental health is one of the most pressing global issues today. With our fast-paced lifestyles, shiny new gadgets and endless newsfeeds, the insidious effects of social media can be so subtle that we don’t even realize how overstimulated we’re becoming.
With everyone posting a highlight reel of their lives on social media, everything has become a comparison game, distractions abound, and it has become easier than ever to neglect our emotional wellbeing in a never-ending quest to avoid FOMO.
In tandem, the prevalence of smartphone addiction has been accelerating. For instance, American smartphone owners checked their phones around 47 times per day in 2017. Studies have found a link between smartphone addiction and declining emotional wellbeing, although it’s unclear whether this is a direct link, or a result of insomnia caused by the blue light emanating from phone screens.
It should come as no surprise, therefore, that global mental health has declined in this age of distraction. In 2017, studies estimated that 970 million people worldwide were suffering from a mental health disorder, a 12.4% increase from 863 million people in 2007.
Subsequently, many people seeking help have turned to the telehealth industry, which boomed to a market value of US$587.9 million in 2018, and is predicted to achieve US$3,918.40 million in revenue by 2027. Mental health apps are some of the key players leading the “Self-Care Revolution,” a phenomenon that has been gathering momentum during the coronavirus pandemic.
Ironically, many problems that these apps claim to solve have been induced by social media and technology. This has prompted skeptics to question their legitimacy, suggesting that self-care apps may even endanger our wellbeing. So let’s dive in, and check out whether these apps are indeed worth the hype.
Headspace: Mindfulness Meditation
The first app at the forefront of the mental healthtech movement is Headspace, which along with direct competitor Calm, enabled mindfulness meditation to break into mainstream media. The Headspace appeal lies in its ethos of “meditation made simple,” projecting itself as a beginner-friendly platform.
Characterized by a simple orange dot as a logo, the app places meditations into categories ranging from stress and anxiety to work and fitness. This encourages users to incorporate mindfulness into their daily routines to foster “focus, calm, and clarity,” as Co-founder Andy Puddicombe said in his 2012 TED Talk.
That talk has currently amassed 11.8 million views, but Puddicombe may be more familiar to Headspace regulars as the friendly, reassuring voice that guides 66 million users spread across 190 countries through quick, everyday meditations.
While the app may be geared toward creating quiet moments, the Headspace business has created plenty of noise, having raised $215.9 million in total over seven funding rounds.
The app also received celebrity endorsements from the likes of Bill Gates, Ryan Reynolds and Gwyneth Paltrow. Award-winning musician John Legend serves as Headspace’s Chief Music Officer. Legend and Headspace aim to add a new dimension to the mindfulness experience through music.
Headspace says it has undergone 70 clinical trials and appeared in 25 peer-reviewed publications. While scientific studies may validate the efficacy of Headspace’s mindfulness methods, however, the hype surrounding the app may outweigh the app’s effectiveness.
“The issue is that people really want it – it’s a commercial product. And when they get a chance to be in a study where they get access to it for free, they approach it with a lot of expectations of getting something special,” said University of Pennsylvania’s Emeritus Professor of Psychology James Coyne in an August 2020 interview with MSN News.
In essence, Headspace may merely act as a useful therapy supplement, which poses new questions about how the company presents itself to the public.
“We really have to think twice about what we’re giving to people,” said Beth Israel Deaconess Medical Center Director of Digital Psychiatry John Torous, in the same story for MSN News. “We probably have to make sure things work a little bit better before providing them as big and population-level solutions.”
BetterHelp was founded in 2013 by Alon Matas and Danny Bragonier. The app matches patients with therapists and counselors. Users then have sessions through text messages, phone and video. Within a few short years, the startup flourished into what is arguably the largest virtual counseling service in the world.
BetterHelp says it is compliant with HIPAA regulations, thus protecting sensitive information. This may eradicate a common concern over how securely the app stores user data. However, it wasn’t always clean and simple for the e-counseling app.
In 2018, the company found itself in hot water when viewers noticed that it was sponsoring YouTube influencers, who were then accused of profiting off emotionally vulnerable fans; consequently, one of the very things that had popularized the counseling service nearly led to its downfall.
Moreover, people found red flags in BetterHelp’s Terms of Service–the company could not guarantee that its professionals were licensed, nor did it confirm that the app could correctly match the appropriate counselors to users. Instead, the company placed the onus of verifying the counselors’ qualifications on the users.
Since then, the company has removed the disclaimer that it could not guarantee the qualifications of its therapists or counselors. Matas claimed that “with our rigorous vetting process, [the disclaimer is] simply unnecessary.” BetterHelp now claims to ensure that counselors have at least three years of experience, among other necessary qualifications.
Despite this debacle, BetterHelp seems to have bounced back successfully. As of now, the company reported that it has hosted nearly 91 million therapy sessions on its platform. This seems to indicate a certain level of repeated use by patients, and could also reflect the merits of virtual counselling.
Still, the BetterHelp controversy shows that there is no shortage of issues to look out for when it comes to mental health apps, despite the physical and financial convenience that they can provide, which traditional therapy may lack.
What do the experts say?
Opinions among professionals are greatly divided, with some acknowledging the potential benefits that digital therapy can offer us, while others are not as keen on mental health apps.
In the wake of scrutiny, many apps, including BetterHelp, have added a disclaimer admitting that their services are designed for patients with mild issues, and will not suffice in immediate crises. From this, it seems as though traditional face-to-face services may be more reliable than most mental health apps for treating patients.
That said, some solutions have been approved by official medical institutions like the UK’s National Health Service (NHS). The apps Daylight (which alleviates stress and anxiety) and Sleepio (which uses CBT techniques to ease insomnia), were provided to NHS Scottish staff in the wake of the COVID-19 pandemic. Both apps have been accredited by the organization.
Moreover, a study that tested the effectiveness of mental health apps claimed that there were no notable changes when they replaced outpatient sessions with an app. In fact, it concluded that mobile apps had “significant potential to deliver high-efficacy mental health interventions,” due to a lack of access to mental healthcare in rural areas and psychiatrist shortage.
Furthermore, mental health apps enable users to retain a sense of anonymity while seeking help. They “allow for privacy and confidentiality and can be a safe space for individuals who may be too ashamed to admit their mental health issues in person or who may feel that they will be negatively labeled or stigmatized by others,” says Dr. Sal Raichbach, PsyD, LCSW.
She added that “the ideal app will also have mental health practitioners onboard, ready to answer questions, plus a 24/7 support hotline for more severe cases.
In short, using mental health apps is a double-edged sword, and the telehealth space, which perhaps owes its success partially to social media giants, is one to look into carefully. While these apps have had a positive impact on millions of lives, until they are more clearly regulated and more transparent about their business models, we have to keep in mind their shortcomings when considering whether to use one to enhance our own lives.