At WHQ, we talk a lot about emerging technologies in healthcare and the myriad benefits they bring to all of our lives. After all, who could fail to be moved by the truly fascinating advances that AI is bringing into the operating theatre, or AR to rehabilitation, or Voice to symptoms management? Every week, we’re hearing about new healthcare innovations powered by emerging tech, and every week, real lives are being changed for the better because of them.
When it comes to mental health, the needs and challenges of those needing support are very different. According to MIND, in the UK approximately 1 in 4 people will experience a mental health problem every year. And while the number of individuals experiencing mental health issues hasn’t fluctuated much over time, there are still a lot of contributing factors that can make both coping, and reaching out for help, very difficult. As such, those who find themselves needing support are not accessing the care and treatments on offer – recent reports have suggested that only 1 in 8 adults with a mental health problem are currently receiving treatment. There’s not one healthcare professional that wouldn’t like to see that number increase, so does the mobile app have something to contribute here?
Mobile apps and mental health – a growing support mechanism
The NHS, along with the US-based National Institute of Mental Health (NIMH), have both reported mental health apps to be “cost-effective, scalable solutions to addressing the mental health treatment gap”. As such, the number of mHealth apps with their focus on mental health has been steadily rising over the years. WHOs 2015 survey of 15,000 mHealth apps revealed that almost 30% had a focus on mental health diagnosis, treatment, or support. To drive the point home, the NHS has its own (rapidly growing) Apps Library, today housing over 70 mobile apps, all of which have undergone both technical and clinical reviews.
Hazel Jones, programme director of NHS Digital’s Apps and Wearables team, “The NHS Apps Library holds over 40 apps to help people take control of their own health and care, tackling issues from chronic obstructive pulmonary disease to self-harm. There have been over a quarter of a million visits in the last year and more than half of those were from mobile phones, which shows how patient access to health care is transforming. It’s telling that mental health apps make up 28 percent of the library, yet account for 59 percent of the visits, with eight out of ten of the most visited apps (in April ‘18) being for mental health”
Smartphone-based mobile apps are opening up a whole new world of opportunities when it comes to the treatment of mental health issues. Here are the ones that caught our eye on release and which are bringing real change to users lives …
Serious mental illness (SMI) currently affects between one and two per cent of UK adults, many of whom remain at high risk of a relapse episode following the first. The trick is to help prevent relapse, which can oftentimes result in hospital admission. Not only can this be (traumatic) for the individual involved, it can be equally upsetting for family and friends, not to mention extremely cost-inefficient.
The ClinTouch mobile app looks to address this, acting as an early warning system for people recovering from psychosis, schizophrenia and bipolar disorder. By enabling users to monitor and manage their symptoms with the hope of reducing or eliminating relapse, the app asks users several times a day how they feel, with responses uploaded to a secure server. CareLoop professionals can then access the information and assess whether or not intervention is required. If a relapse seems likely, an alert is generated so that the right help and support can be sought out.
The good news is that ClinTouch has been found to detect early warning signs of relapse sooner than the more oft-used methods (recording symptoms in medical notes), with more timely interventions helping prevent relapse and hospital admission. What’s more, ClinTouch users reported greater understanding of their illness as a result of using the app, and the daily symptom monitoring that it offers.
In 2017, just over 25% of 11 to 16-year olds in England with a mental health problem said they had self-harmed or attempted suicide at some point. Since then, 123,138 people in the UK have downloaded NHS-approved private app Calm Harm, which supports such individuals to self-harm less often – or not at all. Developed by Stem4, the award-winning app was conceived to support young people in managing the urge to self-harm. According to the NHS, Calm Harm works on the principles of dialectical behaviour therapy (DBT), a type of talking therapy that’s been shown to be effective in supporting people with mood disorders. Encouraging users to distract themselves from the urge to self-harm and supporting them to manage their “emotional mind” in more positive ways, the app delivers four ‘task’ categories that target the most common reasons people self-harm:
- Distract: encourages self-control, lessening the urge to self-harm
- Comfort: encourages care over harm
- Express: motivates expression of feelings in positive ways
- Release: supporting safe, positive alternatives to self-harm
Dr Nihara Krause, the clinical psychologist responsible for developing Calm Harm has said that over 90% of the app’s users have reported that it has helped with managing suicidal thoughts and intent. The app is also used to support individuals struggling with other impulse-control issues such as OCD and eating disorders.
BMJ “Mental health apps directed at young people have the potential to be important assessment, management and treatment tools, therefore creating easier access to health services, helping in the prevention of mental health issues and capacitating to self-help in case of need.”
At some time during their life about 1 in every 100 people will experience a schizophrenic episode – with around 220,000 people in the UK alone being treated for schizophrenia at any one time. It’s a serious condition, symptoms of which include hallucinations, delusions, muddled thoughts and changes in behaviour – but the good news is that around 25% of people who suffer with schizophrenia will go on to recover completely …
Effective self-management is important for individuals living with schizophrenia, and yet the very condition itself means that they may be less likely to attend consultations, and therefore less likely to be able to effectively manage symptoms. The MindFrame app was developed to address this by providing easy access to a range of resources and functionality to support self-management, resources such as self-assessment tools, action plans, and medication insights and alerts.
The app has proven effective in providing users with the motivation to keep to medication requirements, stay on top of their illness in real-time, and to seek the appropriate help when they need it. This, in turn, gave app users greater visibility and insight into their condition, with the result that they reported feeling more in control of it.
With its focus on supporting individuals suffering with conditions such as depression and
Anxiety, MoodPath enables its users to track and monitor symptoms, and to communicate these to their care providers.
Depression and anxiety are two of the most common mental health conditions in the world, causing those affected to experience a wide range of symptoms – everything from depressed moods, loss of interest, and difficulty sleeping to extreme anxiety, low energy, feelings of low self-esteem and loss of appetite. We all know someone who is living with, or has experienced, either depression or anxiety- and with statistics reporting around 1 in 4 of us will experience one of these at some point in our lives, it’s small wonder that looking at ways to effectively manage them has remained a high priority for health professionals. Today, there is a wide range of apps available to do just that and providing the much-needed support for those living with these conditions so badly need.
MoodPath is one such app that has garnered both positive feedback and results. Prompting users to respond to in-app questions regarding symptoms in real-time for a period of two weeks, the app then provides a detailed summary at the end of the fortnight which the user can then share with their health provider so the appropriate support can be given.
MeeTwo is an award-winning app providing fully moderated support and help for teenagers in a safe, neutral space that encourages positive feedback, helps build confidence and fosters resilience during these formative years. What’s more, the app’s easily accessible educational and creative resources (including links to many UK charities and helplines for teenagers) means this app has gained both popularity and credibility amongst its key users.
“I actually didn’t realise how much better this app can make someone feel. I love being able to ask my own questions, and just the experience of being able to help just one other person helps me to feel happier too.” MeeTwo user
So what makes it so popular? MeeTwo is built on the ‘peer support’ model – where individuals help each other – and offers an accessible communication platform to teenagers with access to a smartphone (ie, most of them!) While communication platforms certainly aren’t in short supply when it comes to apps, MeeTwo is different because it’s curated by qualified psychologists and ‘super peers’ (undergrad psychology students), all of whom provide the necessary support, advice and guidance to app users who may be seeking it. Social media can be a minefield for teenagers who don’t yet possess the life skills to navigate its often very choppy waters. The difference with MeeTwo is this moderation – teenagers can open up and say what they want and need to in a safe and supportive environment … there’s no trolling here, and users are encouraged to be open and honest, without any risk of abuse. And it’s not all verbal – MeeTwo actively encourages young people to creatively express themselves, with the chance to have work published. The ripple effects are huge … increased confidence, the ability to connect with others and communicate honestly, and the ability to provide useful, positive feedback to others. It’s this peer-support and open communication model that sets MeeTwo apart from other mental health resources – it feels far more like a social media tool than an app that falls under the ‘mental health’ umbrella, and users like that.
Of course, there is a more ‘serious’ side to MeeTwo which also provides a directory of specialist help groups so if they need to, users can reach out beyond the app to find issue-specific support that they might need. Even better, this is all done privately – no need to worry that others can see what users are looking at or exploring. This all-round neutral space for teenagers is important – helping them develop emotional intelligence, peer support and social skills. It’s one of our favourite apps for young folks, and we’re looking forward to seeing more like it in the very near future.
Security & Mental Health Apps
Life for most of us these days means consuming information online, with our phones being the primary source of that information. Providing people with the tools to take control of, and manage their own health through our smartphones makes perfect sense, but it’s not Pokemon we’re playing with here, it’s our health and the very personal, very sensitive information that goes along with it. It’s difficult, if not impossible, to make an informed decision about using an app to manage mental health if users don’t know who has – or will – have access to that information, particularly when users may feel especially vulnerable As such, it’s critical that security resides at the very heart of these apps, built in at the start of any development work, and governed by stringent regulations and addressing questions such as who will the data be shared with, where is it going, and do I want these people to see my personal information? If individuals are to confidently use and trust these tools, it’s critical that everyone involved has clarity around the data security and governance elements of these apps, after all, the ramifications of non-secured data in this context are huge.
While it’s a fact that a mobile app can’t replace professional support and help, quick access to the support mechanisms that mental health apps often offer can be invaluable, providing support as diverse as quick access to resources, availability of tools to manage symptoms and provision of real-time analysis of patient input so individuals can be directed to appropriate help if needed.
Mental health Apps have enormous potential to scale much-needed resources, providing support to vulnerable people who are either unable or hesitant to reach out for traditional face-to-face support. So whether it’s a peer-support driven app providing safe space for teenagers to connect and share, or a mood-tracking app that alerts users to input information that can ensure they’re effectively managing condition symptoms, the mobile app can be a highly effective tool for supporting those struggling with mental health.