CHRISTINA FARR 04.21.16
Original article on fastcompany.com
Millions of people with mental health disorders, including depression and bipolar disorder, are not getting the help they need. The World Health Organization (WHO) estimates that up to 50% of people in developed countries and 85% in developing ones lack proper access to treatment.
But many of these underserved people do have access to smartphones. And a simple search on Apple’s App Store yields hundreds of apps, which claim to do everything from diagnosing depression to treating insomnia. As you might imagine, these apps range in quality. Some are peddling pure snake oil (one app recommended that people with bipolar disorder drink hard liquor during manic episodes) while others have been independently peer-reviewed by scientists and researchers.
I asked three experts to weigh in on whether mental health app makers have an ethical obligation to back up their claims with clinical evidence. Here’s what they had to say.
LET’S UNDERSTAND THE OPPORTUNITY BEFORE WE TRY TO MAKE MONEY FROM IT
John Torous, clinical fellow and senior resident in psychiatry at Brigham and Women’s Hospital in Boston, Massachusetts: How would you react if your doctor told you the medication she is recommending for your life-threatening infection has never been actually tested, studied, or evaluated? The foundation of health care is trust. So why should the standard be any different for mental health technologies, like smartphone apps that claim to offer either diagnostic or therapeutic guidance?
We have clear evidence that some apps can cause harm, or are ineffective; and many make boastful claims that are simply not true. While opponents may claim that clinical studies take too long to generate evidence, there are new models of research like Agile Science that can facilitate rapid results. And there is the simple truth that if you want to claim an app is effective for long-term care, then you simply have to study it in the long-term. Instead of science and evidence-based information from which patients and clinicians can make informed decisions about mental health apps, there is currently a lack of clinical outcomes data and a world rife with bold claims and promises.
Thus the real question is not should we have evidence for these apps, but why is it currently acceptable to make claims about mental health outcomes with no supporting data? Is it stigma against mental health, belief that patients and clinicians will accept low standards, or a drive for commercialization that has created a landscape where many are making bold claims about mental health that resemble snake oil rather than science? I believe that smartphone technology for mental health will likely grow and evolve into useful clinical tools as we begin to better study and understand them, rather than sell them.