Richard Latham, CEO and co-founder at Wellmind Health, looks at the current state, developments and trends of the mental health app sector.
With over 10,000 mental health-related apps estimated to be available on the market, the industry is truly established and here to stay. As with most markets, there are differences in the levels of quality and efficacy between products, which all make bold claims about their benefits; and, as choice proliferates, individuals become more selective about what they choose to buy. This is particularly so for apps relating to something as personal and sensitive as mental health.
Delivering mental health apps is a complex business, requiring app developers to master a challenging mix of psychology and technology. It’s also an exciting and rewarding sector to be involved in. It provides the opportunity to help improve the mental health of millions of people who have access to a mobile device and want to work to improve their mental wellbeing, whether by personally purchasing a tool to do so or being prescribed one by their healthcare provider.
Challenges of efficacy and adoption
Many of the so-called ‘mental health’ apps available for purchase by individuals would arguably fall more into the category of ‘personal development’ tools. This can be problematic if people with genuine mental health issues come to these apps expecting them to be a quick fix. The lack of understanding of individuals of the importance of checking official ranking and certification for psychological apps needs addressing.
Apps that have been clinically proven to work are ones which are able to deliver all the benefits of real psychological interventions, such as CBT or MBCT. A wider increase in the knowledge of the clinical effectiveness of established psychological therapeutic interventions like CBT and MBCT would be valuable as, in general, people still do not rate these therapies as seriously as pharmaceutical interventions, despite the evidence base.
Another challenge, with MBCT for example, is that for it to be effective it requires someone to meditate on a regular basis and carry out mindfulness practices over a period of at least four weeks. A digital app is highly relevant for overcoming this challenge as it enables MBCT to be delivered right into the heart of someone’s daily life.
Rising trend in clinical usage
In the context of healthcare, providers are past the stage of curiosity about the effectiveness of mental health apps and now see them as part of the healthcare mix of solutions. Digital mental health solutions need to provide reassurance and effective help to patients while being a meaningful tool for clinicians that allows them to understand and monitor their patients’ progress.
In addition, healthcare providers are looking to make use of apps that are economical as well as effective. Academic and clinical research reveals the significant cost savings to providers of digital tools, such as a 45% reduction in the NHS healthcare costs of chronic pain patients who were given our Pathway through Pain app.
Rightly high hurdles in healthcare
The most established and effective mental health apps are already becoming integrated with psychological face-to-face services. This is a highly complex challenge for healthcare providers and the app producers, who have to ensure the highest standards of data security, accessibility, clinical safety and duty of care for the app user.
To assist healthcare providers, there are now lists of apps that have been assessed and passed the stringent requirements. For example, the NHS Health Apps Library was established two years ago and lists only apps that have passed rigorous NHS quality standards for clinical effectiveness, safety, security, usability and accessibility.
As a listing on the NHS Health Apps Library is reserved only for tools deemed clinically safe and secure, it would take at least two years to achieve these healthcare standards from launching an app, even if a new entrant to the mental health app space has deep pockets and invests heavily in this process.
The COVID-19 effect
The COVID-19 pandemic has caused a surge in the use of mental health apps by individuals and healthcare providers. The mental strains created by the pandemic have led more people to seek assistance with their mental wellbeing, and the need to continue treating patients, combined with the necessity of reducing face-to-face contact to reduce the spread of the disease, has made healthcare providers more aware of the remote solutions available. At Wellmind Health alone, we have seen around a 50% increase in the enquiries about and uptake of our Be Mindful app since the start of the pandemic.
Healthcare providers who were not using remote solutions prior to the onset of the pandemic have now seen for themselves how digital psychological tools can be as effective for some people as face-to-face treatment, and the use of mental health apps has been permanently elevated to a higher level.
The question of fees
A topic of discussion in the health apps sector is payment structure: a one-off cost versus a subscription fee for using an app. In clinical standard therapies, individuals will undergo one course of a therapeutic intervention, which in many cases will improve their condition dramatically. This means they no longer need to carry on with this therapy on a monthly basis. They may revisit elements of the techniques they have learned to use as coping mechanisms in the future, but in most cases, individuals will not need to revisit the entire intervention.
The beauty of established psychological therapies is that they are evidence-based interventions to improve people’s mental health for the long term. The ability of people to access these therapies from any mobile device, whenever they need it, for a one-off fee, will be an increasingly important way of helping those in need in my opinion.