How to Pick the Best Digital Therapy App for Your Mental Health

A 2018 study in Nature counted 318,000 mobile health apps in existence, running the gamut from obesity apps to diabetes apps to apps on overall mental health. The rise of digital therapy for mental health has the potential to address two of the biggest hurdles to in-person therapy: high cost and time restraints. Other negative attitudes toward therapy — concerns about confidentiality and a dislike of seeking help — can also possibly be solved with a personal phone app.

But just because there are 318,000 mobile health apps out there doesn’t mean they all work. In a 2019 Nature study, researchers evaluated 73 mental health apps, representing the most highly ranked apps from Google Play and iTunes. They discovered that, while 64 percent of the apps claimed effectiveness at diagnosing a mental health condition, or improving symptoms and mood, the effectiveness of only two apps could be backed up by a study. And while 44 percent of the apps used scientific words in their app description, only half of those apps were associated with any sort of evidence in academic literature at all.

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The 2019 study backs up an investigation by the same authors who discovered that when it came to apps claiming to help depression, 38 percent of app store descriptions included wording related to claims of effectiveness. Meanwhile, just 2.6 percent of those actually provided evidence to substantiate the claims.

"Not all mental health apps are equal

“Not all mental health apps are equal,” psychologist Melanie Badali, Ph.D., tells me. “Some apps are based on scientific evidence and are shown to have mental health benefits, whereas other apps are ineffective, or even potentially harmful, and can have privacy flaws. It’s worth spending a little time looking into the credibility of an app — it will save you time, and possibly money, too, in the long run.”

Judson Brewer, Ph.D., is also careful to point out that just because an app uses the word “based on science” in its description, that doesn’t mean it is actually based on science. Brewer, the director of research and innovation at Brown University’s Mindfulness Center and an associate professor of psychiatry, happens to help create apps that are based in science.

In 2012, Brewer founded MindSciences, a digital therapeutics company to bring scientific discoveries out of the “ivory tower” of academia and into the hands of the people who can benefit from those discoveries. 

“I’m a psychiatrist, so I’m always very interested in making sure whatever I do is actually helpful for patients,” Brewer tells me. “I’ve always had this vision of having my research be applicable.”

Apps to for Binge Eating, Unwinding Anxiety, and Quitting Smoking

MindScience hired three Yale undergrads to build out their first mobile app, and the smoking cessation app Craving to Quit was born. Subsequent studies have shown that the 21-day “mindfulness-based wellness program” is twice as effective as the American Lung Association’s Freedom From Smoking program, and actually decreases neural responses to smoking cues.

His other applications have found similar success. A clinical study that evaluated Eat Right Now, a MindScience digital therapy designed to help people overcome binge eating, showed a 40-percent reduction in craving-related eating. Initial data from the Unwinding Anxiety application shows that, on average, it leads to a 48-percent reduction in anxiety after 28 modules. These programs are not free — but they also appear to work.

Brewer designs his applications to meet what he hopes is the “gold standard” of digital therapeutics. Programs that can explain, in theory, why their service works, can explain the brain mechanism that underlies the “why,” and prove these explanations with clinical outcomes in randomized control trials.

See if the Program Is Backed Up by Proper Studies

He advises that, if you’re looking to pick out a digital therapeutic to use, it’s of service to you to see if the program is backed up by proper studies and explain how their service works mechanistically. Studies are the gold standard, sure, but they are also very expensive and take years to conduct. Often times, applications backed by entrepreneurial companies are most interested in making something consumer-friendly and lightly scientific without putting in the time and cash.

“If something is claiming something wild, it’s probably not true,” Brewer says. “Life just doesn’t work that way.”

Is It a Good Fit for Your Problem?

Badali advises that when picking a digital therapy, it’s important to ask questions like whether it comes from a credible source, is it clinically effective, and if it’s a good fit for your problem. She notes that while it’s currently not clear from academic research precisely who the ideal candidates for e-mental health are, these interventions are most likely to be an appropriate option for people who have “an increased risk of developing mental health problems” or “mild-to-moderate symptoms or functional impairment.” In other words, they are people seeking prevention and early intervention.

Brewer describes digital therapeutics as “just one tool that synergizes with other tools.” They can be complementary to your life rather than a panacea to your problems. And, when you find the right application, it can really work. There are legitimate applications that are proven to help people with a variety of issues, like insomnia and substance abuse. Sometimes, digital therapy can be just as effective as in-person therapy — and at a lower cost.

Now Look at This Oddly Satisfying Thing

Posted to r/oddlysatisfying by u/tzseadog, this is, in fact, a video of window shades closing. But it’s an extremely nice video of shades closing! Trust me.

A version of this article first appeared as the Sunday Scaries newsletter. Sign up for free to receive it on Sundays.