Follow-up on the effectiveness of mental health apps



For the last month, I have been trying out apps that aim to improve mental health of users. I installed the following apps: Headspace, Calm, Whats Up and Dailyo and aimed to use at least one of these every day for the month of January. Below, I will give my impression and opinions on these apps and whether I believe I learnt anything from using them.


Headspace:

When I installed Headspace, it asks me what my reason is for using the app, so it can be targeted at a specific area. It adds a disclaimed straight away that Headspace has not been proven nor is intended to diagnose, treat or cure disorders. So at least it’s being honest!



Aside from a basic introduction course, short animations and advice sound pieces, there is not much available that you don’t have to pay for first. What I found interesting is that there are meditation exercises for children under 5 as well as students, therefore it can be targeted for most ages. I enjoyed watching the short animations to help explain thought processes, these were very cute and good to reflect on.

Screenshot from a short animation on ‘noting’


Overall, Headspace offers primarily guided meditation and short courses on help with how to meditate, with focus on certain areas such as Stress, anxiety, personal growth and life challenges. Without paying £74.99 a year or £9.99 a month, I cannot say upfront whether these courses are beneficial. And I think for something which claims itself to have not been scientifically proven for its effectiveness, it’s debatable as to whether it is worth spending this amount of money when there is probably a wide range of targeted guided meditation videos on YouTube for free.

Calm:

I liked the feel of the Calm app. You can select a relaxing scene and sounds to play while on or away from the app in the background, which are very aesthetically pleasing. These is a Breathe section where you follow a dot around a circle and the circle expands and contracts as it tells you when to breathe in and out. This can potentially be very useful in times of sudden panic or stress. Calm also focuses on guided meditation as well as incorporating relaxing music, sleep stories (although there is only 1 for free) and short programmes e.g. 7 days of focus and Mindfulness at Work. These are focused on meditation and mindfulness techniques, and learning to change your core beliefs and negative thinking patterns (although only the first session is available on a select few programmes.)









There was a programme called 7 days of Calm which was entirely available for free so I listened to I completed this programme in the evenings for 7 days. This programme was focused on learning to meditate, focusing on the breaths and trying not to let the mind wander or get distracted. After completing this, I do feel like I can ‘master’ meditation a lot better than previous attempts, and I use the techniques in the programme to help ‘clear my mind’. I actually used what I learnt from the programme last week when I was feeling quite stressed. I sat in a dark room and focused on my breaths for just a few minutes to allow myself time to ‘recharge’ before continuing my busy schedule.

‘7 days of calm’ programme

Similarly to Headspace, most of the content can only be unlocked when paid for. Calm is £37.99 per year so relatively cheaper than Headspace. The introductory content is probably good enough on its own but I would be more inclined to pay this amount if I were interested in completing more 7 day programmes in the future.


Whats up?:

Honestly, I used this app the least, mainly because it is not as interactive as the other ones I tried. Whats Up? feels very reminiscent of Cognitive Behavioural Therapy (CBT) techniques. There is a section on Coping Strategies – including: unhelpful thinking patterns, metaphors, managing worries and positive steps. The Help Right Now includes a Get Grounded activity where it gets you to name 5 different ice cream flavours for instance to help distract.

There’s also lots of useful information regarding different mental health issues, uplifiting quotes, positive affirmations and breathing techniques. There is also a diary section where you can enter whatever you want and then rate your day as well as adding any positive or negative habits you would like to work on.

Overall, there is a lot of reading information on this app. I think this would be beneficial for those who are wanting to get into CBT but are maybe on a long waiting list to be seen or fear actually attending therapy sessions and talking in-depth about difficult subjects.

Dailyo:

Dailyo is what I have been using the most in January since it only takes a minute out of my day- it’s all about speed and efficiency with me!

Dailyo involves keeping a mood diary, whereby you can rate how you feel at any precise moment using a scale (the labels on the scale can be edited by yourself to keep it personalised). You can then add any activities you have been up to such as work, sport, good meal etc. I really like the simplicity of this app and how you can add your own activities onto the list (I added university, dogs, organised and yoga).





Once you have collected enough entries, you can look at your stats. This is where I get excited because I love a good graph! You can view your daily average mood, which activities were most popular (mine was overwhelmingly and unsurprisingly work), and see a chart of your mood and notice any peaks or dips. I think this is a good app for monitoring your mood changes and being able to reflect on how your day is going so far.


Out of all of the 4 apps I have tried, I think I will continue using Dailyo, but at the end of the day, you use whatever suits your needs!

Again, I have measured my social anxiety using the Liebowitz Scale. 

My previous rating on 30th December was 45 (for fear), 41 (for avoidance), which is a total of 86 overall, and labelled as ‘severe social phobia’.

After completing the scale again on 1st February, my rating is now 38 (for fear), 36 (for avoidance), which is a total of 74 overall, and labelled as ‘marked social phobia’.

I’m very surprised that the rating is significantly lower than that just over a month ago! However, it is of course hard to say whether these mental health apps have lowered my anxiety, or if other variables in my life have contributed to feelings less anxious. I have since started university again and earned a promotion at work, so perhaps these have contributed to improving my mental health.. who knows?!

Do apps for mental health actually work?

There is a frightening and persistent statistic that 1 in 5 people have a diagnosable mental health condition, the prevalence being greater among young people aged between 16-24 years old, with most conditions presenting themselves by the age of 18. Of course it is important to treat these conditions so they do not worsen into adulthood or lead to people developing other conditions which will be trickier to treat.

However, according to many studies, only around 25% of young people under the age of 18 with a diagnosable mental health condition will actually access professional help. There are many barriers to seeking help such as financial constraints, fear of being stigmatised, feeling uncomfortable or vulnerable discussing mental health problems and long waiting lists to be seen by a professional. Similarly, although evidence-based interventions such as cognitive behavioural therapy (CBT) are available, services which provide these treatments are limited. Because of all these barriers, it could be that other forms of receiving treatment can help more young people in desperate need of support. 

Image result for cbt
CBT aims to challenge negative thoughts, behaviours and emotions

Studies have found that computer-based CBT and acceptance and commitment therapy (ACT) provides a way of increasing access to evidence-based interventions for children and young people and has shown to be effective in promoting mental health (e.g. Pennant and colleagues, 2015; Viskovich & Pakenham, 2018). 

However, with the increasing number of young people who now have mobile phones, it is suggested that mental health applications can provide a platform to delivering quick access to interventions. Using mobile apps may reduce the barriers to accessing mental health treatment, and potentially be more effective than face-to-face therapy since there is more anonymity,  can be accessed anywhere and provides immediate support (Gulliver, Griffiths & Christensen, 2010).

There have been countless apps designed in recent years, with an aim to target a spectrum of mental health conditions, e.g. depression, anxiety, OCD, addictions, insomnia etc. 

On the Mind charity website and Psycom there is a list of many apps. While taking a look through them, there are many that claim to incorporate CBT techniques such as ‘What’s Up?’, ‘Rise up’ and ‘Catch it’. Other apps such as ‘Dailyo’ and ‘Worry Watch’ use diary approaches to keep track of thought processes. There are also apps which primarily use guided meditation and breathing exercises such as ‘Headspace’ and ‘Calm’. 

Image result for calm app
Screenshot from ‘Calm’
Image result for worry watch
Screenshot from ‘Worry Watch’

Also, there are apps which give the opportunity to speak to a trained therapist (with a charge). This could provide an alternative to those who need therapy but who fear leaving the house due to their mental health. 

Despite so many mental health apps being readily available to install, the majority of them do not have any evidence-based support for their effectiveness. On Mind, they even put a disclaimer that they are not able to recommend any particular apps and that the apps should not be used as a replacement for seeking medical help.

There is little information regarding how valid the symptom assessments are, which apps are effective or how well the apps compare to face-to-face interventions (Olff, 2015). A systematic review in 2017 investigated publications between 2008 and 2016 on the efficacy of mobile apps for mental health in young people. They found that usage of the apps had little effect on mental health outcomes and found that very few had undergone any research evaluation. Given that the number and pace of mental health apps which are produced, it is important to evaluate their effectiveness, otherwise individuals will be trying to cure their conditions with something that potentially does nothing. It could be that anxiety is increased due to the self-diagnosing tools of these apps and there could be an over-reliance on the effectiveness of the apps whereby people avoid seeking professional help as they believe the apps will fix everything.

While the majority of apps are not supported by evidence, health experts believe mobile mental health treatment will play an important role in the future of health care and gives more people the treatment they need that is not readily available in face-to-face form. 

Without thorough investigation into these apps myself, I cannot give too much information on them. As someone who has undergone counselling and CBT for my anxiety, it would be interesting to see whether the quality of the apps is comparable to real-life therapies. Therefore, I will be installing a few of these apps to try them out for the whole of January and I will give my verdict on them at the end of the month! 

I will be installing ‘Calm’, ‘Headspace’, ‘What’s Up?’ and ‘Dailyo’ to test out apps which claim to offer something a bit different from each other. I will be mostly focusing on managing my anxiety and will target my use of these apps with this in mind. 

I’ve collected a score of my social anxiety using the Liebowitz Social Anxiety Scale and have got a score of 45 (for fear), 41 (for avoidance), which is a total of 86 overall, which apparently means I have ‘severe social phobia’ (oops!). I did the same scale approximately 6 weeks ago and got the same score (so I can kind of see that my degree of social phobia hasn’t changed much over that amount of time). I will collect my social anxiety score at the end of January and see if there is any marked difference, or if I have been cured completely! Obviously there are holes in my experiment and it’s hard to control for everything but it’s just a curiosity test for myself. 

As long as I don’t get distracted, I should post again at the end of January, so I’ll see you all then!


Picture credit: https://mrc.ukri.org/funding/science-areas/neurosciences-mental-health/

About sharing your child’s success on social media

It is not surprising to hear that social media use is massive right now, with more than 35 million people in the UK having a Facebook account alone.

Social media comes with many benefits such as being able to connect, stay in touch with people easily and many people being able to turn to online groups to help with issues they find hard to discuss outside of the internet (myself included).

However, it is worrying to hear that 1 in 5 children worldwide now experience mental health problems, with rates of depression, anxiety and suicidal tenancies increasing into the 21st Century (Bor and colleagues, 2014). One argument is that higher rates of anxiety in particular could be down to technology use. This post is a brief reflection on parent’s use of social media to share children’s success.

When I am scrolling idly through Facebook at around September time, my feed is often flooded with ‘First day back at school’ pictures of children in their brand new school uniforms, clutching their backpack, with an apprehensive grin on their little faces. These often being accompanied with captions from parents exclaiming how smart they look and that they grow up so fast! This is one example of how from a young age, even sometimes before birth, parents can document their child’s entire lives on social media.

Although it is understandable that we would want to show family and friends our children reaching big milestones and succeeding, perhaps it is important to consider the implications of doing this.

Firstly, if another parent is viewing the success of a child of a Facebook contact, it is natural to compare the success of that child to their own. For example, if a parent posts about how their baby has started to walk at the age of 10 months and your own child started walking at 13 months, it could make you believe that you could have done more to get your child walking earlier. Documenting success online could therefore become a bit of a competition between parents. This isn’t to say that we cannot be truly happy for the success of other children and their parents, but we also cannot help but to compare our lives to those we see online (Vogel and colleagues, 2014; 2015).

Parents can also post about how proud they are that their child achieved good grades or their end of year report was really good, followed by commenters congratulating them or saying how clever their child is. If their child is old enough to use social media themselves and reads these posts, they might feel proud of themselves, but they may also feel pressured to keep achieving (Luthar and colleagues, 2018). This added stress to their already stressful experience of school could be detrimental to their mental health, be a major cause of anxiety or feeling depressive symptoms if they do not live up to their parent’s standard. As stated in my previous post, Perceived parental pressures on girls from wealthy families and the effect this has on their mental health and wellbeing, parents can have a profound effect on their children’s mental health. Children can often perceive parents to be pressuring them to succeed. Whether this is true, intentional or not, if a child sees parents posting about their success online, it makes sense to believe that this can contribute towards this perceived parental pressure.

While it is good to celebrate successes of children and to be proud of them, it is important to think about how documenting parts of their life can affect them. There is a lot more research needed in this area to see how posting about the successes of a child can affect their mental health. It is possible that only children from high achieving families would be affected by parents documenting their success, or perhaps there are gender or age differences. All of which are something to look into in future research.

This post is not intended to criticise parents in the slightest, these are just topics that keep me up at night!

Have a good weekend, friends!