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If you have been looking for a therapist or psychiatrist lately, you have probably found yourself on the back end of a long waiting list. The pandemic has taxed not only those that take care of our physical health but those that care for our mental health as well. Many people who are in need of mental health services are simply unable to find a provider who is taking new patients, and some are turning to mental health apps to help bridge the gap in care.

It may be tempting to turn to an inexpensive app for help, but are they safe and effective? And there are thousands of them, so which one do you choose? After all, they all claim to promote mental well-being. And who is monitoring these apps to make sure that they are in line with the standard of care?

In 2017, it was estimated that there were at least 10,000 mental health apps available that claimed to help with everything from insomnia to anxiety to addiction and even schizophrenia using tools like diaries, games, and chatbots. In 2020, the Food and Drug Administration relaxed its standards for digital mental health products, creating a true free-for-all in an already crazy atmosphere where it’s like the 5-year-olds have been fed nothing but sugar. At that point, everyone wanted a piece of the highly lucrative mental health app business. And lucrative it is; Deloitte Global predicted that worldwide spending on mental health apps will reach $500 million in 2022.

Unfortunately, most of these apps are unregulated, and while some are probably safe and useful, others have questionable, or completely nonexistent, privacy policies and don’t have any research to back up their claims.

So how do you make informed decisions about whether or not you should spend your hard-earned cash and time on one of these apps? Let’s take a look at what the experts say.

Who Would Benefit From an App?

The goal of therapy, any therapy, is to gain insight into your own feelings, thoughts, and behaviors. After all, an unexamined life is not worth living. Digital mental health apps can facilitate that much like step counters can help maintain and encourage exercise goals. And some mental health apps, like ones that teach deep breathing, are helpful because that skill has been proven to help reduce stress and anxiety.

But, for some people, apps just aren’t the way to go. For those with low motivation or severe illness, therapy with an actual person may not only be more effective, but vital to their well-being.

Can Mental Health Apps Be a Substitute For Therapy?

In a single word, no. Mental health apps are not meant to be used as a substitute for therapy that is directed and tailored for you by an actual person, especially if you have debilitating symptoms. A mental health app is only going to be fully effective when used in tandem with therapy. These mental health apps should assist people in determining if they need to seek the services of a mental health professional, track physical symptoms, or help with “homework” that therapists give to their patients.

Mental Health App Regulation

While the FDA regulates a small subset of apps that offer diagnosis or provide treatments, for the most part, there is no government regulation or oversight of the apps that are out there. This means that makers of these apps can make marketing claims that are inaccurate or contain potentially harmful information. And the inaccurate information can be deadly; a 2021 paper highlighted regulatory gaps in digital health apps, revealing problems such as inaccurate phone numbers for suicide crisis lines.

To make matters worse, these apps are not required to comply with the Health Insurance Portability and Accountability Act (HIPAA), which means that they don’t have to do things to protect users’ information the way hospitals and clinics do. The same 2021 paper highlighted a 2019 study that found 29 of the top 36 apps for smoking cessation and depression shared user information with Google and Facebook, but only 12 of them revealed this in their privacy notices.

And while these apps claim to be effective, a recent study concluded that an app that was supposed to help those with schizophrenia performed no better than a placebo. This proves, once again, that just because something is popular doesn’t mean it’s effective or safe.

How to Choose an App

Rather than looking for the most popular app, you should make an informed decision about which is the best match for you and your needs.

A good place to start is Mind Apps, which was created by clinicians at Beth Israel Health in Massachusetts. It has reviewed over 600 mental health apps and is updated every six months. These mental health experts look at factors like security and privacy issues, cost, and if the app is supported by actual research.

One Mind Psyberguide is a website that is affiliated with the University of California in Irvine, and it annually evaluates over 200 health apps on credibility, privacy and security, and user experience.

What to Look For In a Privacy Policy

First and foremost, find out if the app even has a privacy policy. A 2019 study found that fewer than 50% of depression apps had a privacy policy, and some apps require you to enter your information before you can see the privacy policy.

Second, you should always read the fine print. While websites like MindApps and Psyberguide present a general overview of each app’s privacy policy, you still must do your own due diligence.

Pay attention to what type of information the app collects, what security measures the app takes, how it uses user information for advertising purposes, and whether it sells, barters, or loans user information to third parties.

If you are uncomfortable with the type or amount of information the app collects, or if they don’t have a privacy policy or their privacy policy falls outside your comfort zone, find another one.

Are Any Apps Reputable?

Most mental health professionals speak highly of mental health apps that have been developed by the federal government. Mindfulness Coach, CPT Coach, and PTSD Coach are just a few, and not only are they free, but they are well-studied, and their privacy policy indicates that user information will never be shared with a third party.

Other apps to consider include CBT Thought Diary, DBT Coach, Virtual Hope Box, and Breathe2Relax. The University of California at San Francisco’s Psychiatry and Behavioral Sciences department maintains a list of apps on its website, many of the apps are free to use.

Final Thoughts

While turning to a mental health app may seem like a good substitute for person-on-person on the surface, the safest and most effective mental health help comes from an actual person who tailors a care plan just for you. That plan may include using a mental health app, but it should be in tandem with therapy, not as a complete replacement. If you do choose to use a mental health app, be sure to read their privacy policy closely, and remember that most do not have to comply with HIPAA regulations. And if for those who have a significant mental illness such as schizophrenia, or symptoms that seriously impair their lives, a mental health app will not be a safe and effective substitute. The bottom line is that mental health apps can be a useful tool to be used with a mental health care plan, but they can’t be a substitute for one.

Copyright © 2022 Lauren Lynn Bradley MA, BSN, RN