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Technology has opened a new frontier in mental health support and data collection. Mobile devices like cell phones, smartphones, and tablets are giving the public, doctors, and researchers new ways to access help, monitor progress, and increase understanding of mental wellbeing.

Mobile mental health support can be very simple but effective. For example, anyone with the ability to send a text message can contact a crisis center. New technology can also be packaged into an extremely sophisticated app for smartphones or tablets. Such apps might use the device’s built-in sensors to collect information on a user’s typical behaviour patterns. If the app detects a change in behaviour, it may provide a signal that help is needed before a crisis occurs. Some apps are stand-alone programs that promise to improve memory or thinking skills. Others help the user connect to a peer counsellor or to a health care professional.

Excitement about the huge range of opportunities has led to a burst of app development. There are thousands of mental health apps available in iTunes and Android app stores, and the number is growing every year. However, this new technology frontier includes a lot of uncertainty. There is very little industry regulation and very little information on app effectiveness, which can lead consumers to wonder which apps they should trust.

The Pros and Cons of Mental Health Apps

Experts believe that technology has a lot of potential for clients and clinicians alike. A few of the advantages of mobile care include:

• Convenience: Treatment can take place anytime and anywhere (e.g., at home in the middle of the night or on a bus on the way to work) and may be ideal for those who have trouble with in-person appointments.

• Anonymity: Clients can seek treatment options without involving other people.

• An introduction to care: Technology may be a good first step for those who have avoided mental health care in the past.

• Lower cost: Some apps are free or cost less than traditional care.

• Service to more people: Technology can help mental health providers offer treatment to people in remote areas or to many people in times of sudden need (e.g.,following a natural disaster or terror attack).

• Interest: Some technologies might be more appealing than traditional treatment methods,which may encourage clients to continue therapy.

• 24-hour service: Technology can provide round-the-clock monitoring or intervention support.

• Consistency:Technology can offer the same treatment program to all users.

• Support: Technology can complement traditional therapy by extending an in-person session, reinforcing new skills, and providing support and monitoring.

• Objective data collection: Technology can quantitatively collect information such as

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• location, movement, phone use, and other information.

Current Trends in App Development

Creative research and engineering teams are combining their skills to address a wide range of mental health concerns. Some popular areas of app development include:

Self-Management Apps: “Self-management” means that the user puts information into the app so that the app can provide feedback. For example, the user might set up medication reminders, or use the app to develop tools for managing stress, anxiety, or sleep problems. Some software can use additional equipment to track heart rate, breathing patterns, blood pressure, etc. and may help the user track progress and receive feedback.

Apps for Improving Thinking Skills: Apps that help the user with cognitive remediation (improved thinking skills) are promising. These apps are often targeted toward people with serious mental illnesses.

Skill Training Apps: Skill-training apps may feel more like games than other mental health apps as they help users learn new coping or thinking skills. The user might watch an educational video about anxiety management or the importance of social support. Next, the user might pick some new strategies to try and then use the app to track how often those new skills are practiced.

Illness Management: This type of app technology adds additional support by allowing the user to interact with another human being. The app may help the user connect with peer support or may send information to a trained health care provider who can offer guidance and therapy options. Researchers are working to learn how much human interaction people need for app-based treatments to be effective.

Passive Symptom Tracking: A lot of effort is going into developing apps that can collect data using the sensors built into smartphones. These sensors can record movement patterns, social interactions (such as the number of texts and phone calls), behaviour at different times of the day, vocal tone and speed, and more. In the future, apps may be able to analyse these data to determine the user’s real-time state of mind. Such apps may be able to recognize changes in behaviour patterns that signal a mood episode such as mania, depression, or psychosis before it occurs. An app may not replace a mental health professional, but it may be able to alert caregivers when a client needs additional attention. The goal is to create apps that support a range of users, including those with serious mental illnesses.

There are no review boards, checklists, or widely accepted rules for choosing a mental health app. Most apps do not have peer-reviewed research to support their claims, and it is unlikely that every mental health app will go through a randomized, controlled research trial to test effectiveness. One reason is that testing is a slow process and technology evolves quickly. By the time an app has been put through rigorous scientific testing, the original technology may be outdated.

Currently, there are no national standards for evaluating the effectiveness of the hundreds of mental health apps that are available. Consumers should be cautious about trusting a program.