Even before you download an app to help you meditate, or to manage your depression, it’s speaking to you. Apps’ marketing often implies that everyday stresses should be seen as mental health issues, and that you’re on your own (with the help of the app, of course) to fix whatever is wrong with you.
These messages kept turning up in the 61 apps that were reviewed in a recent study led by Lisa Parker of the University of Sydney. I spoke with her about what some of these messages are, and why they’re problematic.
You’re on Your Own
The mere existence of apps implies that you and the app can, together, solve your problems. That goes double if the app was recommended by your therapist or doctor.
But social support is hugely important – having a support network can help you manage your mental health better, and you might need professional help as well. The apps were largely silent on that, Parker says.
Meanwhile, the reasons you’re having mental health issues in the first place might have something to do with factors in your life you can’t fully control. There’s a fine line between focusing on what you have the power to control, and feeling bad that you haven’t managed to control things you can’t control.
You’re also on your own when it comes to determining whether the app is appropriate for you at all, but how are you supposed to know? For example, Pacifica states: “We give no representation or warranties about the accuracy, completeness, or suitability for any purpose [of our] advice.” So the responsibility is all on you. That’s a lot for someone who’s seeking help.
Not Everything Is a Mental Health Problem
We all have stresses and disappointments in our life. If you have a mental health issue, these stresses can exacerbate or trigger your symptoms – for example, a deadline can set off a panic attack or an afternoon of unfocused worrying. (Ask me how I know.) But that doesn’t mean that anyone who worries about a deadline has a mental illness.
Some apps reviewed in the study described mental health issues in terms of everyday problems, like feeling tired or irritated. Some implied that you had a problem if you weren’t happy and positive all the time. And others defined mental health problems in a way that included not achieving success in some area of life, like schoolwork or relationships.
None of these amount to symptoms of mental illness, except as part of a bigger picture. For example, if you’re so depressed you can’t do your homework, then sure, you’ll fall behind at school.
Constant talk about being “at risk of” mental illness is also potentially problematic. “I worry about that message,” says Parker, because it gives the impression that human beings are fragile. You’re not going to accidentally slip into mental illness just because you didn’t use an app.
The People in the Apps May Be Nothing Like You
Apps make assumptions about their users. Even though mental health issues cut across boundaries of race, class, and more, most of the apps seemed to assume that their users are white, middle class, employed, and part of a loving family. “Even something as simple as a mindfulness app, they show white people with families going to the orchestra,” Parker says.
That’s okay if you fit that profile, but many folks don’t. If you’re in a marginalised group to begin with, scrolling through all of these apps can make you feel even more alone. And if you’re dealing with serious stresses, like poverty or homelessness, your life may look very different from the idyllic images in the apps.
Apps Want You to Keep Using the App
Some apps include a test to help you figure out whether you have a condition the app can help with. Parker is wary of these, because they’re likely to be biased toward whatever will keep you using the app. If you don’t have a problem, then you could be wasting your time. And if you do have a serious problem, you could end up delaying treatment because you’re hoping the app will help.
Apps also want you interacting with them a lot. Maybe there are reminders every day (or several times a day) to check in. Maybe they end up making you feel bad for not sticking with your program. Even if an app is helpful, it may not be worth all of the time and effort that it requires.
How to Find the Least Bad Apps
There aren’t any solid rules that can lead you to the right app. There may not be a perfect app for you, since few to none of the apps currently available have been tested to see if they improve users’ mental health.
If you must use an app, Parker says, it helps to know about the messages they’re sending, so you can spot them and question them rather than letting them seep in and make you feel discouraged. She recommends watching out for privacy issues, ad tracking, or subscriptions that you’ll forget to cancel. Decide what you’re trying to get out of the app — say, meditation tracks to help you relax — and choose an app that provides just that.
The American Psychiatric Association has a guide to evaluating mental health apps, but it’s made for therapists and is a bit vague. You’re supposed to do background research on whether the company is one you’re comfortable doing business with; pore through the privacy policy; determine whether there’s any evidence it will actually work; and then consider whether it’s easy to use and whether you can share data from patient to therapist.
Unfortunately, none of these are easy tasks. How do you know what’s worth worrying about in a privacy policy? Do you really know if the app maker is trustworthy? And by the way, almost none of the apps you can download have any evidence base to tell whether they work.
In Australia, the e-Mental Health in Practice website has a comprehensive guide (PDF) to evidence-based mental health resources including apps. But again, this is aimed chiefly at practitioners.
So we’re kind of on our own – exactly when we shouldn’t be. Personally I’ve found meditation apps to be helpful when I need to relax, so I’ll keep using them, but I’ll pay more attention to the messages they send. Mental health apps aren’t automatically all bad (especially if yours comes recommended by a therapist) but it’s important to notice what it tells you and not take the messages for granted.
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