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- Title
Assessment of Mental Health Services Available Through Smartphone Apps.
- Authors
Camacho, Erica; Cohen, Asher; Torous, John
- Abstract
Key Points: Question: What do mental health smartphone apps offer patients, how has the app landscape changed, and are app popularity metrics associated with privacy? Findings: In this cross-sectional study of 578 mental health apps, an app marketplace assessment found that while more apps were collecting passive data, most apps still offered similar foundational features. There was no statistically significant correlation between privacy scores and star ratings, but there was a weak correlation between privacy scores and app downloads. Meaning: These findings suggest that apps on the marketplace offer overlapping features, and metrics such as star ratings or the number of downloads may not provide adequate information about the privacy or efficacy of mental health apps. This cross-sectional study assesses the current state of mental health smartphone apps and the association between app privacy scores and popularity as measured by star ratings and downloads. Importance: As more patients and clinicians are turning to mental health smartphone apps to expand access to services, little is known about the current state of the app marketplaces and what these apps are actually offering in terms of features, privacy, price, and services. Objective: To assess the current state of mental health apps, explore the association between app privacy scores and popularity as measured by star ratings and downloads, and to understand opportunities and challenges facing the commercial app landscape. Design, Setting, and Participants: This cross-sectional study had trained raters using the public-facing M-Health Index and Navigation Database (MIND) to assess and review 578 mental health apps. The sample of apps used in this analysis were pulled from MIND and include apps across various conditions including schizophrenia, eating disorders, sleep, and more. Analysis of these apps was conducted in June 2022. Exposures: There were 578 mental health apps rated across 105 dimensions derived from the American Psychiatric Association's app evaluation framework. Main Outcomes and Measures: App raters assessed each app across 6 categories: (1) app origin and accessibility, (2) privacy and security, (3) clinical foundation, (4) features and engagement, (5) inputs and outputs, and (6) interoperability. Privacy scores were determined by 5 MIND criteria, including (1) having a privacy policy, (2) reporting security measures in place, (3) declaring data use and purpose, (4) allowing for the deletion of data, and (5) allowing users to opt out of data collection. Correlations between privacy scores and popularity metrics (star ratings and number of downloads) were measured. Results: This study included 578 mental health apps that were identified, assessed, and analyzed across 105 MIND dimensions. Psychoeducation, goal setting, and mindfulness were among the top app features. Of the 578 apps analyzed, 443 (77%) had a privacy policy. This analysis of apps with a privacy policy revealed that there was no statistically significant correlation between privacy scores and Apple App Store (r = 0.058, P =.29) or Google Play Store star ratings (r = 0.041; P =.48). The number of app downloads on the Google Play Store, however, was weakly correlated with privacy scores (χ25 = 22.1; P <.001). Conclusions and Relevance: In this cross-sectional study of mental health apps, findings indicate that the current app marketplaces primarily offered basic features such as psychoeducation, goal tracking, and mindfulness but fewer innovative features such as biofeedback or specialized therapies. Privacy challenges remained common, and app popularity metrics provided little help in identifying apps with more privacy.
- Subjects
MENTAL health services evaluation; PRIVACY; MINDFULNESS; MOBILE apps; CROSS-sectional method; SCHIZOPHRENIA; SMARTPHONES; PSYCHOEDUCATION; BIOFEEDBACK training; FISHER exact test; SLEEP; MEDICAL ethics; RESEARCH funding; DESCRIPTIVE statistics; CHI-squared test; TELEMEDICINE; EATING disorders; GOAL (Psychology)
- Publication
JAMA Network Open, 2022, Vol 5, Issue 12, pe2248784
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.48784