Could apps be the answer to our mental health problems? It’s a tempting thought, and one that’s occurred to many developers. A quick search on the App Store brings up hundreds of apps that promise everything from music to calm your brainwaves to a subliminal message generator that will tell you, at a tap, how special you are.
Unfortunately, it’s a bit more complicated than that. Recent research from the University of Liverpool found that just four of the apps in the NHS-recommended depression and anxiety app library have a proven evidence base – online community Big White Wall, mood-tracking system Moodscope, activity log Happy Healthy and stress reduction at work tool Workguru.
That doesn’t necessarily mean apps don’t have a part to play in helping us feel better. As the research itself acknowledges, there are plenty of studies that demonstrate that computer-based psychological treatments can work, particularly those designed and supported by mental health professionals.
“Apps can improve people’s mental health, at a low cost and from the comfort of their own home, but only if done properly,” says health economist Simon Leigh, who co-authored the report.
The best apps solve a problem, and our deteriorating mental health is certainly a big issue. Around one in four of us will experience some kind of mental health issue in our lifetime, but spending on mental health is falling - a drop of £600 million over the course of the last parliament, according to research from the BBC and Community Care.
In 2015, Paul Farmer, chief executive of MIND, estimated that the NHS needs another £1billion to tackle mental health. Apps aren’t cheap to develop – but they’re cheaper than that. And they’re also accessible, a key advantage where real-life services are stretched.
So what do apps need to do in order to be more effective? Having a strong expert presence is absolutely key, says Nicki Sprinz, business director at development studio Ustwo, the studio behind new mood tracker app Moodnotes, which launched in August 2015.
“There’s been quite a lot of coverage about apps being either rubbished or having to admit that they didn’t have the expertise,” she points out. “We wanted to partner with experts who could bring scientific rigour to the product design.”
This led them to partner up with clinical psychologists Dr. Drew Erhardt and Dr Edrick Dorian, founder of US-based developer Thriveport, which already had CBT app Moodkit under its belt.
There have also been concerns around where the data harvested from apps goes: there are few things more private than how someone is feeling. A study of 79 NHS-approved apps found that 66 per cent of those which sent identifying information over the internet didn’t use encryption, and warned that these ‘systematic gaps in compliance with data protection principles’ could put users at risk of data theft.
“We track how often people go in and how often they track a mood but not what mood you are recording,” says Sprinz. “It’s really important from an ethical standpoint how people record their own emotions. It’s a very personal and private matter. In fact, a top priority for users in our second version was having the option to password protect the app itself.”
And apps need to know their limits. Sprinz says Moodnotes is not a substitute for therapy. “A lot of our users are people who are not in therapy but who are interested in improving their emotional wellbeing and their use it as a hybrid journaling and CBT tool.”
Integrative psychotherapist, life coach and couples counsellor Hilda Burke agrees. “There’s no substitute for being in the same room with a therapist. The reservation I have about apps is this: when I work with a client, the actual words they say are less than half of what they are telling me. Usually I’ll know how they’re feeling before they utter a word, perhaps by their body language, eye contact or lack of it, or their posture. I don’t think your smartphone can replace that physical closeness.”
But, she says, they can be a fantastic support tool as a supplement to therapy, rather than a replacement. CBT commonly asks those undergoing the therapy to record their moods, or times when they felt angry. “For many people, apps will do that far more efficiently than a notebook and pen.”
And apps can also fill that service gap. “Say, for example, there’s someone who can’t afford a therapist or lives in an area where there's no therapist for 50 miles. If an app helps someone, I think that's fantastic and I’m certainly not going to knock their personal experience. An app provides something where, before, there was nothing.”