Will mental health apps replace therapists?

May 6, 2021

Lyn Geist

The scale of the problem

Mental illness affects approximately 10% of people, which means that around 792 million people live with some type of mental health disorder. This number is likely higher as many people do not recognize or report a mental illness, especially people living in underdeveloped countries or in the low-income demographic, where attention to mental health is not a primary concern.  

Comprised of different categories mental illnesses include: 

  • depression 
  • anxiety 
  • affective bipolar disorders 
  • eating disorders,  
  • schizophrenia,  
  • intellectual developmental disabilities 
  • alcohol and drug addictions 

Within each category, there are several types of each condition ranging from mild to moderate to severe.  

Seeking treatment

In the early 2000s, nearly half of all American households included someone who had sought mental health treatment. Since 2004, the number of people getting treatment has further risen. In part, this increase is attributed to the fact that the stigma around seeking therapy has become less of an obstacle to getting help. 

In an ideal world and before choosing a mental health app, individuals struggling with a mental illness should first seek treatment from a face-to-face visit with a therapist. Therapists utilize diagnostic tools to evaluate how best to help individuals achieve success. In today’s digital world, people don’t even have to leave their homes to meet with their therapists. Online appointments have become readily available.  

Smartphone therapy

Smartphones are changing the way people approach health and wellness. Calorie counters, fitness trackers, drink water reminder apps and behavioral management tools give people ways to proactively pursue better health. In 2014 about 77 billion healthcare apps were downloaded  to smartphones to help people manage and control their conditions.  

These mental health apps are specifically centered around helping people improve their lives and are designed for conditions like: 

  • Depression 
  • Anxiety 
  • PTSD  
  • Mindfulness 
  • Bipolar disorder 
  • Insomnia 

When used with other meditative therapies, these apps can help mitigate symptoms between therapist visits.  

Apps vary in complexity depending on an individual’s condition. Some apps simply teach relaxation through deep breathing exercises to help manage stress. Others help track mood for people with depression or bipolar disorders. Individuals undergoing cognitive behavioral therapy can use self-help apps that can teach skills and support treatment.  

Do they work?

Some mental health apps are based on positive psychology and aim to help people increase focus, lead happier lives, and relieve stress through meditation and mindfulness.  

Studies show that compared to control groups, people who used the apps experienced significant improvement in their well-being.  The apps helped users build confidence in their ability to cope, improve their mental well-being, and reduce depressive symptoms. 

For example, randomized controlled trials showed a variety of mental health apps improved the mood or users. In one particular study, participants were recruited to test the app MoodMission. This app uses evidence-based cognitive behavioral therapy (CBT) methods to deal with depression, stress, and anxiety.  

Strategies include: 

  • Mediation 
  • Exercise and fitness activities 
  • Yoga  
  • Affirmations and coping statements 
  • Relaxation  
  • Gratitude  

Participants responded to various measures of mental health and wellbeing and were than either asked to download one of 3 apps or to wait for 30 days. They then completed the same measures again. They found that all app participants experienced a significant increase in mental well-being when they used the MoodMission app.  

Researchers believe that mental health apps help because they increase emotional self-awareness, improve mental health literacy, and improve coping skills. By improving their ability to cope, users gained confidence which reduced their depression.  

Are all apps safe and reliable to use?

It is important to keep in mind that many mental health apps make claims without any scientific evaluation. The treatment claims are unclear, and often people view the apps as an alternative to clinical support from a therapist. Responsible mental health apps suggest to at-risk users that they should seek help.  Apps that do not make this recommendation to users, may be providing inferior treatment to vulnerable people.  

To address the potential harm of mobile mental health apps, psychologists are beginning to work with developers as they utilize machine learning to treat mental illnesses. By conducting results-based testing on the benefits of these apps, researchers hope to provide mental health applications that will improve the well-being of the people using them. 

To determine the efficacy of AI apps, they will need to be tested in a controlled setting. Otherwise, there is no way to determine if it will provide help or value for the users.  

Will mental health apps replace in-office therapy sessions?

The trend in the use of mental health apps begs the question of whether mental health professionals are at risk of the app taking over their clients, and lets face it, their jobs. Apparently, this is not the case. People are not replacing apps for in-person therapy but were using them as an adjunct to their sessions with a therapist.  

Though some apps are deemed helpful, they do have their limitations when used alone. The most successful treatments for mental health disorders depend on face-to-face interaction between a therapist and his or her client using proven techniques.  

Individual care and a comprehensive approach to mental health are essential. Psychiatrists, therapists, and psychologists are trained to assess and evaluate mental health disorders, and they can tailor and adjust treatment based on client response.  

A lot of therapy actually happens when the client leaves the therapy office. Clients leave with new skills to address recurring problems, and they must find a way to put those skills into practice. Apps can serve as a booster that will enhance patient progress.  

Though the acceptance of mental health disorders has increased over the last several years, many people are still suspicious about attending therapy. Interestingly, people who had never been to see a mental health professional but downloaded and subsequently gained success using mental apps decided to seek professional help.  

The boost in confidence they felt from the app experience helped them see the possibilities of living without fear. It demonstrated that it was possible to exist in a place of happiness and contentment with a therapist’s help.  

Privacy and quality control

The acceptance of mental illness was accelerated during the COVID19 pandemic that began last year. Isolation, fear, anxiety, loneliness and depression became commonplace in the home and the workplace. Employers were met with problems they were ill-equipped to solve, and employees asked for assistance with coping skills and other work-related issues at a steadily increasing rate. 

Then it comes as no surprise that the pandemic accelerated the development of mental health apps. There are between 10,000 and 20,000 health-related self-help apps combined, and only a small number of these are developed and supported by skilled mental healthcare professionals ready to back them.  

Questions around the quality and efficacy of mental health apps have come to the forefront of professional discussions within the last few years as they try to determine which apps can be beneficial.  

Many apps make claims related to their effectiveness in improving an individual’s ability to utilize skills to self-manage mental illness. These apps will claim to improve mood and symptoms of mental health disorders, but most of these claims are not backed by scientific data. 

People must carefully read and understand the privacy policies of the apps they choose to use. In-person visits to a therapist are protected by confidentiality. Apps may not have the same protections and information could be leaked to public entities.  

To ensure the highest quality and best outcome of these apps, therapists must become more involved in the development and recommendation of therapeutic mobile apps. They must serve as subject matter experts and consultants to companies who are developing the apps and be involved in the testing of their efficacy.  

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