Many youth and young adults prefer seeking online, anonymous help rather than talking with their parents, peers or a professional, according to Ashley Radomski, a Ph.D. candidate in the University of Alberta’s Department of Pediatrics.
And though there is a plethora of mobile applications for mental health (mHealth apps) youth and young adults may be more likely to turn to when their mental health is affecting their physical health, relationships, and academic and work performance, there are pros and cons to keep in mind when using them, she said.
We asked Radomski to provide much-needed advice for choosing mHealth apps, based on her research into how technology-based interventions for depression and anxiety, such as apps and online programs, work in youth and young adults (conducted under the supervision of Amanda Newton, pediatrics associate professor at the U of A and co-developer of Breathe—a pan-Canadian online, self-led anxiety intervention for teens).
“The good news is that mHealth apps have the potential to overcome barriers associated with traditional in-person mental health care, such as geographic location, financial costs and clinician waitlists,” said Radomski.
Many apps can be downloaded free of charge and can be accessed anytime and anywhere users choose.
“Use of mHealth apps can also increase youth’s independence, control, self-awareness and self-confidence in managing their own mental health,” she added.
A growing body of research indicates apps may be a promising option for mental health care by offering tools through the convenience of personal, handheld devices, such as mental health assessment (e.g., checklists of physical signs of anxiety), education (e.g., health management strategies and contact information for local health services), social support (e.g., discussion forums and chats), tracking (e.g. mood diaries) and symptom relief (e.g., teaching of therapeutic techniques).
Radomski strongly discourages relying solely on mHealth apps for help.
“Less than half of all youth and young adults who experience a drastic change in their mental health contact a health-care provider,” she said, adding that mHealth apps are not necessarily designed to be used as a replacement for in-person mental health service, but rather in conjunction with them.
Another con is that, although there is research suggesting some well-designed mHealth apps are effective and helpful for anxiety and depression, “most apps on the market have not been scientifically evaluated since technology development moves faster than research,” she explained.
“Youth, young adults and health-care providers should be discerning when selecting and using apps for self-management of their health.”
What to look for in an mHealth app
Based on Radomski’s research and other published peer-reviewed research, here are some general principles to consider when selecting mHealth apps suitable for youth and young adults:
- Content: “Look for content that incorporates evidence-based strategies and high-quality information,” said Radomski. For example, cognitive behavioural therapy strategies such as reframing negative thoughts, and real-time support such as a mental health expert who can answer questions, may be more effective at improving the mental health of users, she noted.
- Purpose: “A useful mHealth app will encourage self-monitoring of thoughts, behaviours, feelings and tracking of symptoms,” said Radomski. These features are critical in managing your mental well-being, she added.
- Credibility: Look for indications of empirical support, such as references to research or well-studied treatment approaches, and check that the developers have expertise in mental health or have third-party endorsements or professional affiliations with reputable universities or organizations, said Radomski.
- Cost: You’ll want to consider whether there are download fees or ads, and whether there is unrestricted access to app features, she noted.
- Functionality: “Don’t make assumptions about functionality,” said Radomski. Check to see whether the mHealth app offers integration with smartphones and has reliable performance.
To ensure you’ll keep using it, select an app with a pleasing look and feel that is easy to use, has some level of interactivity and personalization, includes relatable topics and examples, and allows for one- or two-way communication for technical, therapeutic or peer support.
“Most apps are not designed to be a ‘quick fix,’ but will provide strategies to support longer-lasting changes in health attitudes or behaviours,” explained Radomski. “Remember, the benefits of mHealth apps typically come with repeated use.”
Three apps to try
“A high app rating provided by the app store does not necessarily mean the app is of high quality,” said Radomski. These three apps are backed by evidence or include evidence-based techniques and are freely available in app stores.
For kids and teens
Always There: Developed by Kids Help Phone, it provides local mental health resources and confidential and anonymous online chat support from a counsellor.
For teens and young adults
MindShift: Developed by AnxietyBC and BC Children’s Hospital, it teaches relaxation, coping skills and strategy planning for anxiety.
For young adults and adults
SAM (Self-Help Anxiety Management): Developed by researchers at the University of West England, it helps users monitor and manage panic attacks and anxiety with multimedia activities and mini-games. It also includes peer social support.