What is the health of mental health apps?
The impact COVID-19 has on our mental health is expected to last beyond any physical health issues. Fears of stigma mean our key workers are amongst the least likely to engage with traditional mental health services(1).
Digital therapies can achieve comparable outcomes to face-to-face therapy(2), and young men and boys say they would prefer online support, advice and counselling(3). But how do you find the right Digital Health solutions? ORCHA has reviewed 584 mental health apps to find the best.
Today, we share a snapshot of the quality of apps across a wide range of mental health conditions, and Dr Tom Micklewright discusses his views on apps that have scored well in ORCHA’s Review. You can also sign up to our next free webinar to learn how Papyrus, the National charity dedicated to the prevention of young suicide, uses apps to support those thinking about suicide.
Health apps are convenient and discreet, easily accessed with the tap of a button. But, amongst the 3,857 mental health apps available in unregulated app stores(3), which apps are safe?
Our Review Team has assessed apps that help people experiencing anxiety, depression, self-harm, panic attacks, and thinking of suicide. Each app was assessed against more than 260 criteria across Clinical Assurance, Data Privacy, and User Experience. We discovered that only 29.6% meet our quality threshold, and this figure dipped far lower for certain mental health conditions. We also identified gaps, where there are no apps designed to meet specific patient needs.
There is no one Digital Health technology that works for everyone with a mental health condition. To achieve good results, an app needs to engage and meet specific needs.
In the below video, Dr Tom Micklewright shares his independent views on mental health apps that achieve good ORCHA Scores and are each designed to meet the needs of specific patient groups, including: children, teenagers, students, those with suicidal thoughts, and autistic patients or patients with a learning difficulty.
Wednesday 26th August 2020, 14:00-15:00 BST
Join our free webinar to learn more about how you can build digital health tools into your mental health patient pathway.
Last year, Papyrus introduced an App Library to offer instant, anonymous help to those thinking about suicide. Papyrus staff are extending their services, using the website’s in-built functionality to recommend apps straight to service users’ phones by text or email, where possible. Papyrus will share details of the programme, which apps they frequently share, and where gaps in the mental health app ecosystem still exist.
Learning objectives:
Speakers:
Liz Ashall-Payne, Founding CEO, ORCHA
Kelly Thorpe, Head of Helpline Services, Papyrus
ORCHA is part of the NHS England National Innovation Accelerator Programme. We work with health bodies across the world to unlock the power of Digital Health, including NHS organisations in 50% of regions. Our vision is to revolutionise care through the safe integration of digital health solutions into all aspects of health and care services, leading to more patient-centred, effective care.
ORCHA provides tailored microsites and prescription services, and helps organisations across the world to integrate health and care apps safely into practice. To find out how ORCHA can help you, please get in touch.
Sources
A full list of sources is detailed below our ‘What is the health of mental health apps?’ blog, which can be found here.
Amongst the 3,857 mental health apps available in unregulated app stores, only a small proportion meet ORCHA’s quality threshold.
The impact COVID-19 has on our mental health is expected to last beyond any physical health issues. The virus itself, as well as the measures to safeguard lives that have come with it, have led to a rise in issues that cause mental ill health, such as loneliness, stress, financial worries, stigma and bereavement. And fears of stigma, mean our key workers are still amongst the least likely to engage with traditional mental health services(1).
Mental health apps can help people experiencing anxiety, depression, self-harm, panic attacks and thinking of suicide. There is evidence to show that digital therapies can achieve comparable outcomes to face-to-face therapy(2), when the content is right and supported by a suitably trained therapist. They can be embedded into services, transforming and extending support for patients.
Health apps are convenient and discrete, easily accessed with a tap of the button. Young men and boys in particular are concerned about the stigma of receiving mental health support and say they would prefer online support, advice and counselling(3).
But, amongst the 3,857 mental health apps available in unregulated app stores(4), which ones are the best?
The Organisation for the Review of Care and Health Apps (ORCHA) has reviewed almost 600 mental health apps that help people experiencing anxiety, depression, self-harm, panic attacks, and thinking of suicide. Each app was assessed against more than 260 criteria across Clinical Assurance, Data Privacy, and User Experience.
Of these apps, only 29.6% meet quality thresholds(5); a figure that drops even lower for certain conditions, including:
Whilst reviewing mental health apps, the team also identified significant patient groups who do not yet appear to have apps that have been built to meet their needs. These include:
ORCHA is calling for developers to get in touch if they have such a solution, or to consider building an app to meet one of these clear needs.
Apps offer a wide variety of features such as real-time monitoring, recording, and gamification, that help increase a person’s understanding and engagement with their mental health treatment. But people who download a mental health app without an assessment are putting themselves at risk.
Before recommending a mental health app, read its independent evaluation on the ORCHA App Library at: appfinder.orcha.co.uk
Sources:
1) Research relating to various groups of key workers…
For healthcare providers:
Ross C, Goldner E. Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: a review of the literature. J Psychiatr Ment Health Nurs. 2009;16(6):558–567. [PubMed] [Google Scholar]
Schulze B. Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry. 2007;19(2):137–155. [PubMed] [Google Scholar]
Wallace JE. Mental health and stigma in the medical profession. Health (London). 2012;16(1):3–8. doi:10.1177/1363459310371080. [PubMed] [Google Scholar]
Adams EF, Lee AJ, Pritchard CW, et al. What stops us from healing the healers: a survey of help-seeking behavior, stigmatisation and depression within the medical profession. Int J Soc Psychiatry. 2010;56(4):359–370. [PubMed] [Google Scholar]
For teachers:
https://www.nuffieldfoundation.org/news/more-teachers-reporting-mental-health-problems-than-ever…. The findings show that around 5% of teachers in England now say that they suffer from a long-lasting mental health problem which has lasted (or is likely to last) for more than 12 months.
For police:
Stuart H. Mental Illness Stigma Expressed by Police to Police. Isr J Psychiatry Relat Sci. 2017;54(1):18-23.
Edwards AM, Kotera Y. Mental Health in the UK Police Force: a Qualitative Investigation into the Stigma with Mental Illness. International Journal of Mental Health and Addiction (2020)
2) Healthcare Conferences UK: Improving Outcomes Through Digital Psychological Therapies & Digital IAPT; NICE: Improving Access to Psychological Therapies (IAPT); Centre for Mental Health: Covid-19 and the nation’s mental health
3) YoungMinds research reports that children and young people often look for support and advice online for their mental health – young men and boys in particular have said they would prefer online support, advice and counselling – but this support is not always available.
4) Analysis of Google Play and Apple Stores, searching for ‘mental health’ matches within the title and description of apps in the fitness and medical categories.
5) Based on ORCHA assessment of a sample of 584 apps, assessing these against 260 criteria across Clinical Assurance, Data Privacy, and User Experience.
Two barriers to mHealth prescription revealed
COVID-19 has led to a dramatic increase in Digital Health within NHS services. But as lockdown restrictions are lifted, experts fear the industry’s mHealth progress could stall or even reverse. The Organisation for the Review of Care and Health Apps (ORCHA) publishes in JMIR mHealth and uHealth research that quantifies for the first time what is most required by healthcare professionals to prescribe Digital Health, and reveals what factors are limiting adoption.
The team at ORCHA found a NHS badge for Digital Health overwhelmingly came in as the most important factor for take-up, followed by peer opinion and personal use of the technology. Although published studies after often called for, these were named, but it would take 5 published studies to be as convincing as one NHS stamp of approval, and 2 published studies to be as convincing as a peer recommendation of the app.
Two factors were also identified that directly correlate with a drop in Digital Health usage. Both patient age and the cost of digital health were linked with a reduced likelihood of prescribing. This is worrying because, as people age and become more susceptible to long-term health conditions, they are less likely to be recommended digital health to manage their health. A drop in prescription for paid-for digital health is also a concern, as it may reflect an inherent lack of understanding of the value digital health brings.
On a positive note, only 8% of healthcare professionals are reluctant to use digital health. These are most likely to be aged over 55 or not using a health app themselves, giving organisations clear routes to target education programmes.
Commenting on the research, Simon Leigh, Health Economist, ORCHA, said: “Now is a critical time for Digital Health. Adoption has rocketed during COVID-19, but as the requirement for remote consultations fades, so too may the industry’s take-up of digital health.
“This research reveals the underlying attitudes and wants from healthcare professionals. It’s important for providers to consider these needs, if the NHS is to achieve its long-term digital transformation ambitions.”
Health economists at ORCHA conducted research with 230 UK healthcare professionals, using a series of focus groups, ranking exercises, and a discrete choice experiment. The research can be found here: https://mhealth.jmir.org/2020/7/e17704/
Dr Tamsin Holland Brown demonstrates and shares her personal views of how these apps can benefit children’s health and wellbeing.
Today, we take a look at some of the best health apps for paediatrics. Dr Tamsin Holland Brown, Community Paediatrician CCS NHS Trust, demonstrates and shares her personal views of how these apps can benefit children’s health and wellbeing.
Of the 259 child health apps we’ve reviewed, 71% score below ORCHA’s quality threshold. It is, therefore, particularly important to understand which apps are quality assured for use within clinical pathways.
The NHS Long Term Plan prioritises ensuring a strong start in life for children and young people.1 Technology has a big role to play in this.
In the video below, hear Dr Tamsin Brown, Community Paediatrician CCS NHS Trust, discuss how the Hear Glue Ear app can help children aged 2-6 who experience hearing loss due to glue ear. Dr Brown’s daughter, Lilac, also explains how the app works, looking at how games are used to develop auditory processing and listening skills through bone-conducting headphones.
Click below to watch the video:
Dr Brown next demonstrates the Rafi Tone app and accompanying Able Spacer and whistle mask (manufactured by Clement Clarke International Ltd). The app is designed to help make using an inhaler with a spacer easier and more fun for young children with wheeze or asthma symptoms, with a whistle tone emitted by the mask when correct breathing technique is used:
Dr Brown explains how The Worrinots app helps children to offload their worries, and how the companion app, Wotnot, allows parents to monitor their child’s concerns. The Worrinots is a secure app designed for children, providing them with a safe place to share their worries, fears and concerns, which in turn provides them with a practical, fun coping mechanism for their fears, using one of the four Worrinots characters:
Sources
1) National Health Executive: NICE recommendations to improve the lives of children, young people