App-based psychological interventions: friend or foe?

Published in: BMJ Evidence-based mental health

With a consistent decline in mental health professionals, and ever increasing demand on NHS services, waiting lists for psychological services have been increasing for some time. In fact, in some CCGs, waiting times as long as 140 days (from seeing a GP to a first appointment with a psychologist) have been reported.

While waiting lists continue to grow, unmet needs grow in parallel with conditions often worsening. The charity MIND determined that one in 6 of those on waiting lists for mental health services are expected to attempt suicide, 4 in 10 are expected to self-harm and two-thirds are likely to see their condition deteriorate before having the opportunity to see a mental health professional.

Health-apps are one solution the NHS has recommended to fill the gap between patient need and he capacity of incumbent NHS psychological services. While some apps may be brilliant, not all apps are equal, and some can even be dangerous.

In 2015 the NHS recommended 14 health-apps within the NHS apps library for the treatment of depression or anxiety, only 4 of which provided any evidence of effectiveness, furthermore, only 2/14 used validated outcome measures.

As such, over 85% of health-apps recommended by the NHS for the treatment of depression or anxiety had no solid evidence to back up their effectiveness.

During a time of unprecedented NHS efficiency savings, the opportunity afforded by health-apps should be welcomed by NHS commissioners looking to extend the provision of high quality mental health services within existing budgets. However, this should not be done so without first guaranteeing the quality of these technologies, as this may result in a worsening of symptoms.


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