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Experts say mental health apps increase people’s access to therapy, but they caution against using them to replace medical professionals. Getty Images
  • There are now 10,000 mental health apps available to download.
  • But experts say many of these apps are untested, and it’s not clear if they can help people with mental health issues.
  • However, these apps could be a key stopgap for people who can’t easily access mental health assistance through traditional means.

Over the past few years, there’s been a boom in mental health apps, with researchers estimating there are now about 10,000 apps of the sort available for download.

The apps offer a range of services, including meditation guidance, telepsychiatry, online therapy, and symptom tracking and management.

The rise in mental health apps mirrors our society’s increased awareness about mental health, encouraging people to take notice of their own mental health state.

But many health experts are skeptical about the effectiveness of most of these apps and whether the technology has what it takes to replace mental health professionals.

From the looks of it, mental health apps aren’t going to replace doctors or therapists anytime soon. Many of the apps haven’t been studied, and most aren’t connected to a healthcare provider or therapist, which puts a cap on how helpful an app can be.

But certain apps — specifically ones that are clinically backed — could become an important tool used in conjunction with in-office visits. When proven effective, these apps could help break down the barriers to mental health treatment.

One of the main problems with the apps is that the vast majority aren’t clinically proven.

“Most of the apps out there, if tested at all, compare their outcomes to nothing — like wait lists or pamphlets — and they generally don’t test it with people who have proven clinical disorders,” says Kathleen Carroll, PhD, the principal investigator at Yale’s Center for Psychotherapy Development.

If an app hasn’t been studied or tested on people, there’s no way to know if it provides any real value.

In addition, if the app isn’t connected to a healthcare system, it’s essentially operating in a vacuum, according to Brita Elvevåg, PhD, a cognitive neuroscientist at the University of Tromsø, Norway.

“That might be okay if I need something to make sure I have good sleep hygiene, that I go to bed on time and get up on time, but if somebody is chronically ill, if it’s not linked to some sort of electronic hospital records or something at the clinic, then if that person starts to relapse, then what good is that device?” Dr. Elvevåg said.

If nobody is being alerted of a person’s decline in mental health that an app is picking up on, the result could be catastrophic.

The apps that are most likely going to shape the future of healthcare are the ones that have been studied and validated.

One app, which was developed by Elvevåg and a team of researchers at University of Colorado in Boulder, is using machine-learning technologies to categorize people’s mental health status and help clinicians better monitor their patients.

The app works by detecting day-to-day changes in speech patterns, which often coincides with fluctuations in mental health.

For example, shifts in tone or pace can be a symptom of mania and depression. Disjointed speech is a key symptom of schizophrenia.

“Speech offers a critical window into a person’s mental processes, and changes as a function of suicidality, depression, mania, delusions, hallucinations, Alzheimer’s and a variety of other mental illness issues,” says Alex Cohen, PhD, the director of the affective science and psychopathology laboratory at Louisiana State University, who helped develop the app.

In early research the app developers said they found signs that the app may be as accurate as clinicians in certain situations. But the goal of the app isn’t to replace clinicians — it’s to help transform behavioral and clinical assessment by giving mental health professionals another tool to pick up on subtle speech cues and warning signs.

CBT4CBT is another promising app. Founded by Dr. Carroll at Yale, the app uses interactive exercises, movies, and graphics to help people stop using drugs and alcohol.

In clinical studies, the app proved to be just as effective, if not more, than in-person consultations, according to Carroll.

“Our first trials evaluated CBT4CBT as an add-on to standard substance use treatment, and we showed that it improved substance use outcomes and patients really liked it. Our later trials showed that with just minimal clinical monitoring (a ten minute check-in every week or so), CBT4CBT did better than standard treatment and the effects lasted longer,” she told Healthline.

And patients preferred CBT4CBT to group treatment. “Coming in to a treatment center and sitting in groups isn’t attractive to a lot of people,” Carroll added.

Her team found that like clinical cognitive based therapy (CBT), the app’s effects are highly durable and provide lasting benefits: People actually learn the skills they’re trying to teach, she said.

But even when the apps are studied, it can take a long time before we’re able to make use of them.

“With tools in a research phase, there can be months and years before meaningful results are produced,” says Dr. Terje Holmlund of the University of Tromsø in Norway who works alongside Elvevåg to develop and study e-health tools.

The apps need to get into the hands of clinicians much faster, Holmlund added. Only until they’ve been integrated into clinicians’ daily workflow can they start to make an impact.

Another significant issue is that the vast majority of app users don’t stick with it.

According to a recent study, less than 10 percent of people use mobile mental health apps for more than 10 days.

Dr. Cohen says that most apps are designed for short-term use. There are ways to address this — with gamification and passive recording, for example — but we’re not quite there yet.

Lastly, people still may feel uncomfortable opening up on an app. It can be scary and vulnerable to talk about your mental health, let alone when you’re doing it with an app.

“The challenge is more the human thing,” Elvevåg said. “We don’t trust anybody with our health records, so it comes down to human trust issues, I think, and we’re still not ready for that.”

The development of more medically sound mental health apps could significantly improve access to mental health care.

Most people with a mental health or substance abuse issue don’t get treatment, Carroll said, noting that nearly 90 percent of people dealing with substance abuse don’t get treatment.

This happens for a variety of reasons: Some can’t afford treatment, others don’t have a way of getting to and from an appointment, and some people’s symptoms are so severe they’re unable to function or leave the house.

Furthermore, people who do seek help typically only see their therapists semi-regularly (once a week, a month, or even every couple months). There’s a massive lag in between sessions where all kinds of stuff can happen.

Emotions are dynamic — what a person feels one day could be drastically different the next day or even the next hour.

Apps have the potential to monitor emotional changes on an hourly, daily basis, which can clue healthcare providers into what’s happening during those lags.

“Despite having one of the most expensive mental healthcare systems in the world, we haven’t made a dent in curing these disorders, and treatments offer most people modest improvement with potentially serious side effects,” Cohen said.

As a result, mental health treatment typically falls into the hands of emergency room workers or even prison staff, Cohen explained, adding that anything that can help make our mental health system more efficient and accessible is massively appealing.

And therein lies the big promise of these apps: They’re inexpensive, they can reach millions of people, and when developed properly, can provide people with consistent, reliable treatment.

It’s estimated there are more than 10,000 mental health apps available, offering a range of telepsychiatry, online therapy, and symptom tracking and management services.

Mental health experts say these apps won’t replace therapists anytime soon, but many may soon be used in conjunction with in-office visits.

When developed properly, certain apps have the potential to break down the barriers to mental health treatment and transform the mental health care system.