Technology and the Future of Mental Health Treatment
In its effort to “transform the understanding and treatment of mental illnesses,” the National Institute of Mental Health (NIMH) recently updated its report on technology and mental health support and data collection.
As those of us in the health care industry know, mobile devices like cell phones, smart phones and tablets are giving the public, providers and researchers new ways to access, help, monitor and increase understanding of mental health. However, the NIMH cautions that this technology frontier – and its wave of app development – has much uncertainty. There is little industry regulation and slight information on the effectiveness of the apps.
That said, here are current trends in app development they identified:
Self-Management Apps: “Self-management” means that the user puts information into the app so that it can provide feedback. For example, the user might set up medication reminders, or use the app to develop tools for managing stress, anxiety, or sleep problems. Some software can use additional equipment to track heart rate, breathing patterns, blood pressure, etc., and may help the user track progress and receive feedback.
Apps for Improving Thinking Skills: These help the user with cognitive remediation (improved thinking skills) and show promise. They are often targeted toward people with serious mental illnesses.
Skill-Training Apps: These may feel more like games than other mental health apps as they help users learn new coping or thinking skills. The user might watch an educational video about anxiety management or the importance of social support. Next, the user might pick some new strategies to try, and then use the app to track how often those new skills are practiced.
Illness Management, Supported Care: This adds additional support by allowing the user to interact with another human being. It may help the user connect with peer support or may send information to a trained health care provider who can offer guidance and therapy options. Researchers are working to learn how much human interaction people need for app-based treatments to be effective.
Passive Symptom Tracking: There is a lot of activity around developing apps that can collect data using the sensors built into smartphones. These sensors can record movement patterns, social interactions (such as the number of texts and phone calls), behavior at different times of the day, vocal tone and speed, and more. In the future, apps may be able to analyze these data to determine the user’s real-time state of mind. They may also be able to recognize changes in behavior patterns that signal a mood episode such as mania, depression, or psychosis before it occurs. An app may not replace a mental health professional, but it may be able to alert caregivers when a client needs additional attention.
Data Collection: These apps can gather data without any help from the user. Receiving information from a large number of individuals at the same time can increase researchers’ understanding of mental health and help them develop better interventions.
Researchers find that interventions like these apps, are most effective when people like them, are engaged and want to continue using them. Behavioral health apps have to combine the engineer’s skills for making the technology easy and entertaining to use, with the clinician’s skills for providing effective treatment options.
As mentioned earlier, there are no national review boards, checklists or standards for evaluating the effectiveness of the hundreds of mental health apps out there. The NIMH says that consumers should be cautious about trusting a program and offers a few suggestions for finding an app that may work for you. They are:
- Ask a trusted health care provider for a recommendation. Some larger providers may offer several apps and collect data on their use.
- Check to see if the app offers recommendations for what to do if symptoms get worse or if there is a psychiatric emergency.
- Decide if you want an app that is completely automated or an app that offers opportunities to contact a trained person.
- Search for information on the app developer. Can you find helpful information about his or her credentials and experience?
- Beware of misleading logos. The NIMH has not developed and does not endorse any apps; however, some app developers have unlawfully used the NIMH logo to market their products.
- Search the PubMed database offered by National Library of Medicine. This resource contains articles on a wide range of research topics, including mental health app development.
- If there is no information about a particular app, check to see if it is based on a treatment that has been tested. For example, research has shown that Internet-based cognitive behavior therapy (CBT) is as effective as conventional CBT for disorders that respond well to CBT, like depression, anxiety, social phobia, and panic disorder.
Bottom line? The NIMH says, “try it.” If you’re interested in an app, test it for a few days and decide if it’s easy to use, holds your attention, and if you want to continue using it. An app is only effective if keeps users engaged for weeks or months.