Qaseem: Mental health apps do more good than evil


Yaqoob Qaseem, Columnist

A team at Feinberg recently launched a suite of smartphone applications named IntelliCare to target depression and anxiety. IntelliCare offers each individual personalized suggestions of apps to alleviate mental anguish and constantly evolves in response to feedback from its user base. Thus, the accuracy of the platform continuously grows as time passes and the body of users increases. The potential of these intelligent mobile apps to improve access to mental health care in the U.S., an area in such dire need, is tantalizing. However, the use of health apps is contested by many for a range of reasons.

On Tuesday, The BMJ, a peer-reviewed medical journal, published a commentary between two physicians of opposing views on health apps. The physician arguing in favor of the apps, Dr. Iltifat Husain, said they hold the potential to lessen illness by encouraging healthy behavior. Nonetheless, he commented doctors should play a more active role in educating patients about which apps to use. The physician disputing the use of these technologies, Dr. Des Spence, said the untested nature of the apps leads to diagnostic uncertainty and thus anxiety. Additionally, he noted many apps lead to obsessive self-monitoring.

The possibility of health apps generating anxiety in patients is an ironic misfortune for apps specifically intended to combat anxiety. Nonetheless, claims of inaccuracies in such apps have been substantiated by the Federal Trade Commission’s actions against several dubious technologies. Even in pop culture, WebMD is notorious for its exaggerated diagnoses that generate fear in users of the website.

The information offered by automated healthcare technologies is inevitably dangerous because of the significant chance of misinterpretation. When patients visit a physician, any diagnosis is supported and explained by an educated professional with several years of training. When patients use a smartphone application, the diagnosis is often unverified and the patients are left to interpret the information for themselves. The potential for disaster in these situations is clear and has been a source of controversy for all forms of health care that avert visits to a physician, such as home DNA test kits.

Unfortunately, not everyone in the U.S. has the option to visit a mental health care provider. Indeed, according to the American Psychological Association, a quarter of Americans have inadequate access to such services. Additionally, in a study of a group of mental health patients who considered seeking a physician but decided against doing so, 71 percent of patients agreed they wanted to resolve the issue on their own. The reluctance to visit a psychiatrist due to independence, stigma or other reasons would also be specifically targeted by apps intended to help individuals help themselves.

Given the sheer volume of health apps on the market, regulation is also highly impractical, as Husain noted in The BMJ. Moreover, studies have already shown some mental health apps to be effective, at least in serving as a complement to other forms of therapy by providing ongoing contact with health services. Thus, physicians in the midst of the constantly expanding sea of health apps should focus on educating patients on the limitations of such apps, clarifying the most helpful apps and developing more accurate apps through research.

Feinberg’s IntelliCare serves as an auspicious manifestation of the latter goal. Fueled by a $2.5 million grant from the National Institute of Mental Health, the team will conduct a formal two-year study on the effectiveness of the mental health apps. Additionally, the system’s ability to learn from user interaction represents the aim of increased accuracy. In contrast with many apps currently on the market, the apps of the IntelliCare suite are also designed by clinicians using validated therapy techniques.

Another vital component of ensuring health apps are used effectively is fostering an awareness among users about the potential for incorrect diagnoses. Physicians have a key role to play in this education of the public, and efforts by the media and government agencies could further facilitate the process.

Nearly 20 percent of U.S. adults are afflicted with some form of mental illness. With the high prevalence of mental illness and the lack of access to mental health services, innovative technologies aimed to combat these sinister ailments should not be suppressed due to their pitfalls. Rather, the limitations should be recognized and tackled as the technologies are embraced and improved.

Yaqoob Qaseem is a Weinberg freshman. He can be reached at [email protected]. If you would like to respond publicly to this column, send a Letter to the Editor to [email protected].