Why mental health apps don’t work
The rise of mental health apps have made waves. Companies like Calm have reached valuation of $2 Billion in 2020 and have reached international recognition. As these companies grow and join the list of common apps found on our mobile devices, we begin to see the true nature of mainstream mental health apps is to sell content.
Mainstream mental health apps are advertised using scientific language with little evidence backing their claim. A study in 2019 by Nature Research Journal: Digital Medicine found 73 apps claiming they help substance abuse, depression, anxiety, self-harm, and schizophrenia. 64% of those apps claimed effectiveness in diagnosing a mental condition, improving symptoms, improving mood or self-management. 44% of those apps used scientific language to justify their claims however only 14% of the apps described using clinical design or development and none were backed using accreditation or certifications. In other words, little to no apps are built on research and clinical trials.
Although mainstream mental health apps are commonly found on mobile devices, rarely are they used. Bite-size lessons are used passively adding a layer of difficulty with follow through and forming healthy habits. These are just a couple of the many concerns commonly found in mainstream mental health apps. Let’s look at some key struggles found in mainstream mental health apps.
Mental Health Exercises as “Entertainment”
Bite-size meditations, sleep stories, and even relaxing videos are available to listen or watch passively without addressing the underlying concerns. Although they may be relaxing in the moment or help someone fall asleep, they fail to help the person address their concerns. Just as a Band-Aid is to cover a wound, mental health entertainment content covers the mental health concern. We need the treatment in addition to the Band-Aid to improve the healing process.
Cookie Cutter Approaches
Mainstream mental health apps tend to have packs, courses, or categories of content that address a specific concern. Meditations for Happiness, Managing Anxiety, Navigating your Inner Critic are all common titles found on mainstream apps. A structured approach is not frowned upon however it leads to an assumption that all people find happiness the same way, that all people should learn one way to manage their anxiety, or that an app knows what your inner critic is saying because it’s the same inner critic everyone has. There is no room for individuality within a cookie cutter approach.
Facilitating “Fixes”, not Insights and Coping
The underlying tone found in mainstream mental health apps breathes relaxation, happiness, joy, and other positive human emotions. As if the app has a goal meant for you to achieve. To fix unhappiness, anxiety, poor self-esteem, grief, stress, or any other negative human experience. In reality, these are not passively “fixed” but processed, understood, accepted, and learned coping strategies. That the underlying anxiety may not go away but instead understood and increased capacity to handle anxiety opposed to running from it. Learning acceptance of negative human experiences helps us be present in life opposed to finding ways to navigate through life.
Foster App Dependency
Mainstream mental health apps tap into the streaming content code. The Netflix binge leads to wanting more content to watch. Mental health content works in similar ways and develops dependency. For example, we learn a new meditation that encourages using the app whenever we sit down to meditate or we use soothing sounds and relaxing melodies to fall asleep that leads to habitual use every night to fall asleep. Some apps attempt to teach, however the continued updates and new content through push notifications hits that sweet dopamine spot in the brain wanting us to use more.
This doesn’t mean we should all ditch our mental health app subscriptions. A Band-Aid is still better than nothing at all but there is an opportunity for the rise of Evidence-Based Practices (EBPs) within digital mental health. Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Exposure Therapy are all examples of EBPs that have research and validity backing their treatment model. These treatment models also have libraries of activities and exercises waiting to be transformed into an engaging digital product. Although there are several examples of CBT-based apps in the Apple and Google Play marketplace, rarely do they have the funding and financial support that entertainment-based mainstream mental health apps have.
Building a successful mental health digital product based on EBPs is not the final solution. In addition we need to recognize that people are unique. The rise of machine learning has made its mark in advertising, social media, and echo chambers of one sided news outlets. Using ML in digital mental health products to build individualized treatments while following EBPs creates an opportunity to speak with the user opposed to speaking to the users.
We are naturally social beings. Social connection is built into our neurochemistry, such as mirror neurons, and even our fight or flight response. Yet mainstream mental health apps are isolating and disconnected for this natural connection we crave as humans. Creating a supportive community in conjunction with individualized and engaging EBPs invokes belonging and accountability. Fostering a supportive digital community has it’s hurdles but the need for human connection outweighs the design and development struggles.
The number of mental health apps found on Apple and Google Play marketplaces are well over 10,000 available to download. The amount of choices and oversaturated of mental health apps creates noise that prevents people from finding beneficial and engaging digital mental health products built on clinically validated treatments. Like hitting a bullseye on a dart board from a mile away. With changing the perception of the benefit in investing in mental health apps for VCs and other sources of financial backing will help new EBP apps to rise. From “how do we get people to use the app more?” to “how do we help people get better?” changes the emphasis from app addiction to individual wellbeing as a means of financial growth. By putting clinically validated treatments first is putting people’s mental wellbeing first and that is a tool worth sharing and growing.
Dan Smith is a Licensed Professional Counselor (LPC) in Oregon and Washington. He is also a product designer and consultant specializing in mental health digital products. You can learn more about Dan by visiting his portfolio www.dansmith.pro.
