Professionals and users disagree about quality of mental health apps

Mental health professionals and consumers disagree about the value of different mental health apps, research has found.

The study, published in JMIR, is based on web surveys carried out between December 2020 and April 2021 to find out what people thought of mental health apps. The 11 apps in the survey were: Breethe, Calm, Headspace, Insight Timer Meditation, MindDoc, MindShift, Reflectly, Remente, Sanvello, Self-Help for Anxiety and Woebot.

The 21 consumer reviewers, who all reported a history of mental health problems, were asked to download three of the chosen apps and use them for three days. Researchers then compared the ratings they gave the apps with existing ratings from clinicians and academics.

They found more than half of the app ratings showed disagreement between the study participants and the professionals. On the whole, professionals gave the apps higher star ratings and were more likely to recommend apps to others compared with the consumer reviewers.

The researchers reported that many participants were frustrated when they reached a paywall or needed to pay for premium content. Cost, the researchers write, “was among the most important factors for participants.” Participants also valued certain aspects of mental health apps that were overlooked by professional reviewers, including the ability to track and measure their progress, and having access to educational content, such as information on coping mechanisms or symptoms.

Ease of use is important

“Participants placed a great deal of importance on app functionality, and most themes generated through the qualitative analysis were related to this aspect. They appreciated a variety of features, which were easy to use, interactive and with the capacity for personalization,” the researchers write. “Aesthetics were also very important, as our participants emphasized the importance of a professional layout, with engaging colors and a simple structure. The highest number of participant negatives was for the domain ‘difficulties of use,’ suggesting that current professional ratings are overestimating the ease with which the apps can be used.”

The researchers noted some limitations with the study. For example, although they asked participants about whether they had used mental health apps in the past, they didn’t ask whether they’d use the specific apps used in the study. They also didn’t record participants’ specific mental health diagnoses.

In future, they write, studies could use a larger and more diverse sample of users and focus on different categories of apps. This research used mental wellness apps, not digital therapeutics. Future studies could evaluate how well people understand those categories and the distinctions between those types of apps, they write.

The researchers argue, however, that their study demonstrates that professional reviewers may not focus enough on issues that are important to consumers.

“As reviews on app stores and by professionals differ from those by people with lived experiences of mental health problems, these alone are not sufficient to provide people with mental health problems with the information they desire when choosing a mental health app,” they write. “App rating measures must include the perspectives of mental health service users to ensure ratings represent their priorities. Additional work should be done to incorporate the features most important to mental health service users into mental health apps.”