Exploring the Mental Health App Maze

November 24, 2020| By Johannes Schmidt and Andrew Mills | Life | English | Deutsch

When Apple registered a trademark for the slogan “There’s an app for that.” back in 2010, who could have foreseen just how many apps would be created - and for every imaginable need. With such a big focus on wellness in recent years, it’s not surprising that this market in particular has created a huge number of alternative health apps.

It’s estimated that there are now between 165,000 and 325,000 commercially available health and well-being apps, according to a research article in Nature in 2019. Significantly, more than 10,000 are specifically aimed at mental and behavioural health.

So many mental and behavioural health apps are available that choosing the most appropriate can be extremely difficult for a prospective user, and inevitably there’s a risk of poor choices being made. That could be why, despite the massive initial uptake, the usage rate of an app falls off significantly within a few months’ time.

To help potential users of mental and behavioural health apps “see the wood from the trees”, we have set about answering two important questions: What criteria can you use to evaluate digital mental health applications or online treatment services and their effectiveness? And for what purpose can the app or online resource be used most effectively?

We suggest that certain criteria are needed to categorize and evaluate apps. By using these criteria, you should be able to understand the differences between apps and know what to look out for in order to assess them.

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There are many fundamental questions that need to be asked, including some that might seem obvious.

To start with, what should the app help with and who is it made for? Establish whether the app is for people suffering from a specific mental health disorder or whether it is for a healthy population.

Should the app only give advice for dealing with everyday problems? Does the app contain scientifically validated background information about mental disorder, so that you would say it was designed for psychoeducation? Or is it for prevention, for example, when a person feels stressed or burnt out, to prevent the development of depression or other mental health disorders?

Similarly, it’s important to distinguish between so called “stand-alone treatments” and “blended treatments”. Stand-alone treatment means that participants use only the app chosen and not visiting a psychotherapist.

Blended treatments, on the other hand, are programmes that are used in parallel or integrated with face-to-face psychotherapy.

Another key question is whether or not the app under consideration has a high degree of individualization - for example, employing individualized tasks based on previous data - or does it have fixed, rigid exercises with a pre-defined progression?

A time and a place for everything

In addition to suggesting these and many other questions (see Figure above), we have explored the issue of when an app can most effectively be deployed. We think the most promising areas for apps to be deployed are as follows:

  • A bridge to treatment
  • A complementary service to current treatment
  • Prevention
  • In the context of ongoing management/relapse prevention

If you make the effort to evaluate the mental health apps available in your market by using the criteria described above, you will be in a better position to support insureds in their search for the most suitable apps.

Often, a health insurance company can offer insureds a suitable app and cover the cost for it while the client waits for an appointment to receive personal treatment. Using an app in the meantime, an insured can accumulate a lot of knowledge about his or her illness and integrate therapeutic exercises into everyday life - and possibly feel more motivated, healthy and likely to enjoy going to work again.

It’s important to understand that evaluating mental health apps is not easy. Some scientific evidence shows a positive effect of digital interventions, especially for guided interventions in the field of depression and anxiety. But many apps have not been reviewed scientifically.

If you want to find out more on the use of apps, we will be happy to share our insights - just contact your Gen Re account executive.


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