Rating Mental Health Apps: Does Self-Monitoring Even Help?
With more than 165,000 health apps available — most of them monitoring stuff related to your health in some manner — you might assume there’s a ton of research demonstrating the effectiveness of such self-monitoring. But you’d be wrong.
In the world of mental health apps, there’s virtually no research demonstrating that monitoring your moods will benefit your treatment outcomes.
So why do so many companies and developers offer apps that simply spit back the data you put into them? Is there a rating organization that can help you make sense of all the mental health apps available?
Yes, knowledge is power. The theory goes that the more you know about yourself, the better off you’ll be. Self-monitoring can also help identify triggers in your life — those things that precede a downturn in mood, or an irrational reaction to something. You can then look to reduce those triggers, or be better prepared when a new one presents itself.
Mood monitoring can also be helpful for folks in treatment, so your clinician has an understanding of how your mood varies throughout the week. (Or your clinician could just ask you, but people are often not reliable witnesses to their own feelings retrospectively.) Self-monitoring can also help in understanding whether a given medication is having any positive impact on the patient’s treatment.
It is rather amazing, however, that there’s so little research on whether mood monitoring itself — even with old-school paper and pencil — does any good beyond providing basic information. In my simple search on the term “mood monitoring” in research databases, I found a lot of descriptive studies that explain how a new monitoring tool was developed.
But when I searched for data on whether any of these tools actually help patients directly, research was scarce.
Lauren Durkin (2006) carried out one of the few studies I could find, but it was for her dissertation. In it, she examined the effects of mood monitoring on 43 patients with bipolar disorder. She found that patients who engaged in self-monitoring did not show greater improvements on outcome measures of depression and mania, as compared to clients who did not self-monitor. She also found that the quality of the mood monitoring didn’t matter either — patients who complied more with mood monitoring didn’t have better treatment outcomes.
What Mental Health Apps Should You Trust?
CommonHealth’s Martha Bebinger has the story, asking whether there are any mental health apps you can trust.
“There are tens of thousands of apps, but very few have an evidence base that supports their claims of effectiveness,” says David Ahern, a psychologist who directs Brigham and Women’s program in Behavioral Informatics and eHealth.
Ahern is also looking at how to process all the data that comes in from patients and present it in the most useful way to clinicians. Many doctors and therapists already feel overloaded with paperwork and recording keeping. Ahern says the app and others may free clinicians to handle more patients who need therapy because they won’t need to see a provider weekly or twice a month. The app, says Ahern, may make patients better monitors of their own mental health.
The article goes on to note that there’s no agency or organization that rates or certifies mental health apps (or health apps, for that matter). But Bebinger missed an important service that actually does exactly that: PsyberGuide.
While not comprehensive, the non-profit PsyberGuide overseen by Dr. Michael Knable rates the evidence base for the apps it has reviewed in its database (here are the mood disorder apps, for instance). Some apps even have an in-depth, expert review posted on the site, giving people all of the information they need to know in order to make an informed decision.
Did I mention it wasn’t comprehensive? With tens of thousands of mental health apps available today, PsyberGuide has reviewed less than 1 percent of them. That’s a shame, because it’s an awesome evidence-based service that should extend to all health apps.
Mood Monitoring is Easy
Here’s the thing, though — mood monitoring is incredibly easy and always has been. There’s no need for an app, although an app can help you track your mood more easily over time (and put it into a pretty graph) — if you’re religious about filling out the regular survey questions an app asks you.
In fact, mood monitoring is so simple, some researchers believe it can be boiled down to a single question (van Rijsbergen et al., 2014):
Please rate your current mood on a scale of 0 to 100’, on which 0 indicates ‘happy’, and 100 indicates ‘sad.’
A person who scores 55 and above could be considered someone who might qualify for a diagnosis of clinical depression. (A higher cutoff score of 61 reduces the amount of false positives — people who would not actually meet a clinical depression diagnosis — but also misses more people who would qualify.) You can use this simple rating scale yourself every day or once a week to track your own mood.
Mental Health Apps: Potentially Helpful
There are dozens of mental health apps that are potentially helpful to people, and many are available at low or no cost to try out. I’d encourage people to check out the PsyberGuide listings for more information. It is an independent organization, not tied to any of the apps it’s rating, so it is trustworthy and objective in its ratings.
Does self-monitoring your moods help your condition? On its own, it’s not clear that self-monitoring will do much. While you may become more educated about your moods, it’s also possible such information won’t provide much enlightenment or useful insight.
Read the full article: As The Brigham Tests Mental Health App, Clinicians Debate Efficacy
Durkin, L.A. (2006). Relationship between quality of mood monitoring and treatment outcomes in clients with bipolar disorder. Dissertation Abstracts International: Section B: The Sciences and Engineering, 67, 3447.
van Rijsbergen, Gerard D.; Burger, Huibert; Hollon, Steven D.; Elgersma, Hermien J.; Kok, Gemma D.; Dekker, Jack; de Jong, Peter J.; Bockting, Claudi L. H. (2014). How do you feel? Detection of recurrent Major Depressive Disorder using a single-item screening tool. Psychiatry Research, 220, 287-293.
Grohol, J. (2018). Rating Mental Health Apps: Does Self-Monitoring Even Help?. Psych Central. Retrieved on August 4, 2020, from https://psychcentral.com/blog/rating-mental-health-apps-does-self-monitoring-even-help/