Dive Brief:

• More people are using mental health apps, but evidence of benefits is often thin and not readily available, a new study in Nature shows.
• The researchers looked at 73 top-ranking, consumer-facing mental health apps available through Google Play and iTunes to see what claims were made in app store descriptions, how often scientific language was used to support the claims and whether the scientific literature backed them up.
• Of those, 64% made positive claims about diagnosing, managing or easing symptoms of the following conditions: depression, self-harm substance abuse, anxiety or schizophrenia. Fewer than half (44%) used scientific language to support their claims and a third of those included techniques not found in the literature.

Dive Insight:

The findings are important because, despite the existence of curated libraries for mental health apps, most consumers find and assess health-related apps through personal online searches and popular app stores.

Behavioral health is a medical specialty that has been touted as a good fit for telehealth settings, but self-managing such issues could be risky if patients rely on ineffective apps. Patients and their doctors need a good way of determining which apps to use and recommend.

Of the mental health apps in this study, two described "low-quality, primary evidence" to support their use and only one referenced published literature. Just 14% mentioned lived experience in describing design or development, and none cited recognized accreditation or certification processes such as curated app libraries.

Most of the apps (81%) made claims for a single mental health-related functionality — either self-assessment, symptom or mood monitoring, information or psychoeducation, therapy or treatment, or peer or community support. Just 11% described two or three functionalities, and three apps didn't describe any.

Despite wide use of scientific language to support app claims, only two offered direct evidence related to use, results from a pilot study and self-reported mood changes following app use. Information on one app cited a validation paper for a voluntary questionnaire.

"While these cases represent the best evidence provide by apps in this study, they still fall short of high-quality evidence obtained, for example, from randomised controlled trials," the authors write.

Troubling, too, was the fact that a third of the app descriptions that included scientific techniques referenced principles not backed by published evidence, the study notes. With the FDA piloting a program that would reduce certification checkpoints for low-risk software-based medical devices and apps, there could be an opportunity for researchers to help developers find ways to capture strong evidence and real-world data, the study says.

"In the future, app stores could include standardised data fields allowing developers to provide additional details to support their apps," the authors write. "There has been progress towards mandating that apps include a privacy policy, and this could be extended for health apps by allowing developers to include a PubMed identifier, offering users the opportunity to click through to published articles related to the app, as well as other indicators such as compliance with quality frameworks and lived experience involvement."