High anxiety calls for innovation in digital mental health

mental health_

(Kristina Tripkovic, Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Joshua Gordon, Director, National Institute of Mental Health & Murali Doraiswamy, Professor of psychiatry and behavioral sciences, Duke University Health System


  • Counselling services have become available through apps in response to COVID-19.
  • Studies have revealed a lack of scientific rigour in digital mental health.
  • Research aims to provide real data on the effectiveness of mental health apps.

Are you feeling depressed or anxious? There’s an app for that. Globally, there are more than 400 million annual downloads of mobile health apps, which suggests that consumers are eagerly seeking technology to manage their health.

In the past few months alone, mental health surveys, tips, and counselling services have become available through social media sites and apps in response to the COVID-19 outbreak. For mental health professionals, the opportunity to provide help in this time of crisis – without an in-person consultation – is very desirable.

Mental health is one of the fastest-growing sectors in the global digital health market with more than 10,000 apps that claim to boost your mood, help you sleep, and even help you overcome an addiction.

Earlier this year, researchers reported findings from a mental health survey that helped gauge the prevalence of psychological distress among Chinese citizens during the COVID-19 pandemic – data that could help shape targeted interventions. Moving into the future, there’s no question that mobile apps could play important roles in tracking and treating mental illnesses. But do these apps really work? And is there any harm in trying them?

If your favourite gaming app crashes, you might moan and groan, but you’ll move on. If your photo editing app goes awry, you can start again from scratch. But what happens when a depression chat app fails to give appropriate guidance? The consequences may be severe. Lost in the headlong rush to develop and market mental health tools is the need to ensure that these technological solutions are safe, evidence-based, and effective.

Today, no-one really knows how many people have been misled or suffered a serious ill effect due to a mental health app. But studies have revealed a serious efficacy problem with many of these products. A study of 73 mental health apps, targeting a range of mental health outcomes, found that, while many claimed effectiveness and used science to sell the apps, only two apps provided evidence from research that examined the app in question.

Another evaluation of apps aimed at individuals at risk of depression and suicide concluded that “non-existent or inaccurate suicide crisis helpline phone numbers were provided by mental health apps downloaded more than 2 million times. This demonstrates a failure of the health app industry in self-governance, and quality and safety assurance”.

When it comes to mental healthcare solutions prescribed by clinicians, rigorous testing is required to ensure that people aren’t given drugs or other therapies that do more harm than good. For example, cognitive behavioural therapy went through extensive standardization and many clinical trials before it was considered an evidence-based intervention.

Online demand for mental health apps.
Image: GK Strategy

In the United States, the Food and Drug Administration (FDA) has put similar procedures in place for evaluating some mental health and wellbeing apps. Any app that is intended to diagnose, prevent, or treat a mental illness must undergo efficacy and safety studies to gain pre-market clearance from the FDA.

Most mental wellbeing/health apps, however, fall into a grey zone; they don’t make overt medical claims and are therefore able to avoid the need for efficacy studies or FDA scrutiny. Extreme circumstances – such as a pandemic – can also give regulatory agencies some leeway to push forward therapeutics and technologies faster than usual.

While the lack of rigorous evaluation may be disheartening, the good news is that the situation is changing. There is an increasing number of studies that aim to provide real data on the effectiveness of mental health apps.

For example, a recent analysis of 18 randomized controlled trials of mobile apps for people with depression showed that the use of apps was associated with a decrease in users’ symptoms, with the greatest benefits seen among users who had milder forms of depression.

A major initiative led by 23 partner organizations in Europe and the US, called RADAR-CNS, is rigorously evaluating the utility of a smartphone app for monitoring people with recurrent major depressive disorder. Mindfulness apps are also being studied in innovative ways: in a joint partnership, five University of California campuses and the mindfulness app Headspace are carrying out an eight-week randomized controlled trial examining the effects of the mindfulness app on stress, depression, sleep, heart health, and physical wellbeing in more than 1,000 individuals.

What is the World Economic Forum doing about the coronavirus outbreak?

A new strain of Coronavirus, COVID 19, is spreading around the world, causing deaths and major disruption to the global economy.

Responding to this crisis requires global cooperation among governments, international organizations and the business community, which is at the centre of the World Economic Forum’s mission as the International Organization for Public-Private Cooperation.

The Forum has created the COVID Action Platform, a global platform to convene the business community for collective action, protect people’s livelihoods and facilitate business continuity, and mobilize support for the COVID-19 response. The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.

As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.

For consumers, it’s critical that the safety and efficacy of mental health apps come before flashy design and marketing. We need app makers and regulatory agencies to work together to collect data in both controlled clinical trials and in patients’ daily lives outside of rigorous clinical settings.

For example, China has established free, 24/7 online psychological counseling services, prioritizing patients who have concerns related to COVID-19. Outcomes are being collected and studied. Insights into the quality and effectiveness of these programmes could help people all over the world. Funders, including the US National Institute of Mental Health are already eager to support both early-phase and post-marketing outcomes research that will help ensure safety and efficacy. It’s now up to researchers and app developers to push studies forward.

Effective apps have the potential to change the face of mental health care – not only during pandemics but also in routine daily life. Now is the time to invest and innovate in digital mental health to ensure that anyone, anywhere, can get the help they need.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

UN chief pays tribute to the courage of DR Congo citizens, and the sacrifice of blue helmets

Low productivity jobs continue to drive employment growth

How can we build a workforce for our digital future?

Why the ocean holds the key to sustainable development

One day your doctor might prescribe healthy food and a museum visit – here’s why

7 ways to break the fast fashion habit – and save the planet

EU invests more than €100 million in new LIFE Programme projects to promote a green and climate-neutral Europe

EC v Samsung: A whole year to compile a case

Autumn 2019 Economic Forecast: A challenging road ahead

3 ways to nurture collaboration between universities and industry

Scotland in United Kingdom: It’s either the end or the beginning of the end

A 10-step plan to save our seas

After globalization what? Europe’s long, straining shake-up post Davos wreckage

What keeps me up at night? Two strategists reply

The Silent Pandemic: The impact of the COVID-19 pandemic on mental health

5G networks: to slice or not to slice?

Migration Crisis: how to open the borders and make way for the uprooted

Stop wars disguised as peace missions

Ship Recycling is the Commission’s Titanic

Madagascar: UN Secretary-General reaffirms support for electoral process

Glasgow and Edinburgh race to become the UK’s first net-zero emissions city

Asking for more restriction on intra EU immigration: Unproductive and politically dangerous

3 tech design principles to help curb digital repression

Is your business model fit for the Fourth Industrial Revolution?

Plastic waste from Western countries is poisoning Indonesia

Why Europe is more competitive than the US

Commission reports on progress made by Albania and North Macedonia

Is Data Privacy really safe seen through Commissioner’s PRISM?

How can entrepreneurship tackle the migration crisis in the EU?

EU consumer rules: Airbnb cooperates with European Commission and EU consumer authorities improving the way it presents offers

5 of the world’s deadliest infectious diseases

The Banking Union divides deeply the European Union

3 reasons why responsibly-deployed technology is key to the COVID recovery

5 ways to make your organization a great sustainability partner

Soccer is back with strict COVID-19 rules. Here’s what you need to know

6 young leaders who are improving the state of the world on International Youth Day

Death as a Global Public Health Issue

Nearly half a billion people can’t find decent work; unemployment set to rise: new UN labour report

The road ahead to building a more sustainable world

These Indian fishermen take plastic out of the sea and use it to build roads

Somalia: UN congratulates Puntland region’s newly-elected President

The importance of Yellow September and suicide prevention in Brazil

EU announces €25 million for education in crisis contexts and €140 million to support research in sustainable food systems

Draghi tells the Parliament the ECB to use all its weaponry; euro slides to parity with the dollar

Financial support for workers affected by no-deal Brexit

Youth Internationalization: part of everyday life in JADE

Planes can now fly for 21 hours non-stop. But are people ready?

ECB readies itself for extraordinary monetary measures defying Germany

State aid: Commission approves €1 billion Cypriot scheme to support enterprises and self-employed individuals in context of coronavirus outbreak

Europe divided: 30 years on from the fall of the Berlin Wall

3 things to know about India’s space programme

European Youth Event 2020: giving a voice to young people to influence EU policy

Fairer and clearer rules on social benefits for EU mobile workers agreed

Gender Equality in Medicine: are we now so different from the Middle Ages?

COP21 Breaking News_12 December: The New Draft Agreement!

Common charger: a long-awaited proposal requested by Parliament

Kosovo elections: ‘Most significant change’ in 12 years, Security Council hears

International community urged to deliver on promise for better future for Bosnia and Herzegovina

EU decides “in absentia” of civil society

Europe’s far-right launches attacks on neighboring nations

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: