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The research and expert comment available on the issue:

Apps With Maps - Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores

Conclusions: The current proportion of apps developed using evidence-based frameworks is unacceptably low, and those without tested frameworks may be ineffective, or worse, pose a risk of harm to users. Future research should establish what other factors work in conjunction with evidence-based frameworks to produce efficacious mental health apps.

Marshall JM, Dunstan DA, Bartik W. Apps With Maps-Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores. JMIR Ment Health. 2020 Jun 24;7(6):e16525. doi: 10.2196/16525. PMID: 32579127; PMCID: PMC7381031. https://pubmed.ncbi.nlm.nih.gov/32579127/

Technology and the Future of Mental Health Treatment

This new era of mental health technology offers great opportunities but also raises a number of concerns. Tackling potential problems will be an important part of making sure new apps provide benefits without causing harm. That is why the mental health community and software developers are focusing on:

Effectiveness: The biggest concern with technological interventions is obtaining scientific evidence that they work and that they work as well as traditional methods.
For whom and for what: Another concern is understanding if apps work for all people and for all mental health conditions.
Privacy: Apps deal with very sensitive personal information so app makers need to be able to guarantee privacy for app users.
Guidance: There are no industry-wide standards to help consumers know if an app or other mobile technology is proven effective.
Regulation: The question of who will or should regulate mental health technology and the data it generates needs to be answered.
Overselling: There is some concern that if an app or program promises more than it delivers, consumers may turn away from other, more effective therapies.

The National Institute of Mental Health (USA - Last Revised: September 2019) Technology and the Future of Mental Health Treatment https://www.nimh.nih.gov/health/topics/technology-and-the-future-of-mental-health-treatment/index.shtml

Mental Health Messages in Prominent Mental Health Apps

CONCLUSIONS Mental health apps may promote medicalization of normal mental states and imply individual responsibility for mental well-being. Within the health care clinician-patient relationship, such messages should be challenged, where appropriate, to prevent overdiagnosis and ensure supportive health care where needed

Parker, L., Bero, L., Gillies, D., Raven, M., Mintzes, B., Jureidini, J., & Grundy, Q. (2018). Mental Health Messages in Prominent Mental Health Apps. The Annals Of Family Medicine, 16(4), 338-342. doi: 10.1370/afm.2260 https://www.annfammed.org/content/annalsfm/16/4/338.full.pdf

Clinical or gimmickal: The use and effectiveness of mobile mental health apps for treating anxiety and depression

Conclusion: Research into the effectiveness of mental health apps is lacking, and the majority have no evidence of efficacy. Clinicians need to be aware of what apps have such evidence and should exercise caution when recommending apps to patients.

Clinical or gimmickal: The use and effectiveness of mobile mental health apps for treating anxiety and depression Australian & New Zealand Journal of Psychiatry 2020, Vol. 54(1) 20–

28 DOI: 10.1177/0004867419876700 https://journals.sagepub.com/doi/full/10.1177/0004867419876700

Standalone smartphone apps for mental health—a systematic review and meta-analysis

Excerpt from Abstract

Although some trials showed potential of apps targeting mental health symptoms, using smartphone apps as standalone psychological interventions cannot be recommended based on the current level of evidence.

Weisel, K., Fuhrmann, L., Berking, M., Baumeister, H., Cuijpers, P., & Ebert, D. (2019). Standalone smartphone apps for mental health—a systematic review and meta-analysis. Npj Digital Medicine, 2(1). doi: 10.1038/s41746-019-0188-8

https://www.nature.com/articles/s41746-019-0188-8

The "Hot Potato" of Mental Health App Regulation: A Critical Case Study of the Australian Policy Arena

Implications for policy makers

There are gaps in the regulatory framework for health apps, at least partly because the different sectors involved (medical device, advertising, finance, media content, privacy) are relatively siloed, with no single sector holding comprehensive oversight.

There is a lack of regulatory focus on consumer protection for app users, with regulation instead concentrating on reducing burdens of consumer choice.

Regulatory policies tend to ignore regulatory responsibilities of commercial app stores, which serve as distributers, even though the app stores arguably wield more power in the health app arena than policymakers and individual developers.

Policy-makers in different sectors should work together to develop an overarching regulatory framework for health apps, with a focus on consumer protection.

Governments should put pressure on commercial app stores to change practices in favour of protecting consumer privacy and safety.

Implications for the public

Consumers should be aware that the current regulatory framework is inadequate, meaning that some publicly available health apps may harm their health, finances or privacy. Consumers and advocacy groups should lobby governments and industry for changes in legislation and industry practices that better supports consumer privacy and health safety.

Parker, L., Bero, L., Gillies, D., Raven, M., & Grundy, Q. (2018). The "Hot Potato" of Mental Health App Regulation: A Critical Case Study of the Australian Policy Arena. International Journal of Health Policy and Management (IJHPM), 8(3), 168-176. https://www.ijhpm.com/article_3576_c193c1581dab865d02c2b0ff2e863a45.pdf

Smartphones in mental health: a critical review of background issues, current status and future concerns

Abstract

There has been increasing interest in the use of smartphone applications (apps) and other consumer technology in mental health care for a number of years. However, the vision of data from apps seamlessly returned to, and integrated in, the electronic medical record (EMR) to assist both psychiatrists and patients has not been widely achieved, due in part to complex issues involved in the use of smartphone and other consumer technology in psychiatry. These issues include consumer technology usage, clinical utility, commercialization, and evolving consumer technology. Technological, legal and commercial issues, as well as medical issues, will determine the role of consumer technology in psychiatry.

Bauer, M., Glenn, T., Geddes, J., Gitlin, M., Grof, P., & Kessing, L. et al. (2020). Smartphones in mental health: a critical review of background issues, current status and future concerns. International Journal Of Bipolar Disorders, 8(1). doi: 10.1186/s40345-019-0164-https://link.springer.com/article/10.1186/s40345-019-0164-x

Mental Health Messages in Prominent Mental Health Apps

Suicide prevention and depression apps’ suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines

Conclusions

Non-existent or inaccurate suicide crisis helpline phone numbers were provided by mental health apps downloaded more than 2 million times. Only five out of 69 depression and suicide prevention apps offered all six evidence-based suicide prevention strategies. This demonstrates a failure of Apple and Google app stores, and the health app industry in self-governance, and quality and safety assurance. Governance levels should be stratified by the risks and benefits to users of the app, such as when suicide prevention advice is provided.

Martinengo, L., Van Galen, L., Lum, E. et al. Suicide prevention and depression apps’ suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines. BMC Med 17, 231 (2019). https://doi.org/10.1186/s12916-019-1461-z https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1461-z#citeas

‘Help from the App Store?’

Excerpt:

However, when considering using apps for mental health, there are also potential pitfalls. Disadvantages include technical aspects of delivery, such as screen size, battery life, system updates, technology requirements, as well as usage patterns, such as frequent but brief daily smartphone interactions, attentional competition between apps, short app lifespans, non-private settings, and data-security concerns.¹⁵^,¹⁶^,¹⁷

Terhorst, Y., Rathner, E. -M., Baumeister, H. & Sander, L. ‘Help from the App Store?’: a systematic review of depression apps in German app stores. Verhaltenstherapie https://doi.org/10.1159/000481692 (2018).

Investigating Country Differences in Mobile App User Behavior and Challenges for Software Engineering

Excerpt:

There have also been previous systematic and meta-analytic disorder-specific examinations of efficacy, which found small effects for reductions in total anxiety scores from smartphone interventions compared to control conditions (g = 0.33, 95%CI 0.17–0.48, P < 0.01)²⁰ and small effects for reductions in depressive symptoms from smartphone apps compared to control conditions (g = 0.38, 95%CI 0.24–0.52, P < 0.001).²¹ However, in both reviews, studies were included which did not primarily target depression or anxiety, including apps for memory training and attentional control, so that the effect of apps designed for anxiety and depression remains unclear, as well as the effect of apps individuals explicitly seek as treatment for a specific psychological disorder.

Lim, S., Bentley, P., Kanakam, N., Ishikawa, F., & Honiden, S. (2015). Investigating Country Differences in Mobile App User Behavior and Challenges for Software Engineering. IEEE Transactions On Software Engineering, 41(1), 40-64. doi: 10.1109/tse.2014.2360674

Experts warn on data security in health and fitness apps

Excerpt:

Users of mobile health and fitness apps should not assume that any of their data is private or protected, says a report by the Privacy Rights Clearinghouse, a non-profit privacy group based in San Diego, California.1 For the report the group’s researchers studied the privacy policies and protections of 43 popular health and fitness apps, including apps that allow users to enter information about their diet, daily exercise routines, and medical and mental health conditions; to look up disease and drug information; and to share their information with friends through the app, a website, or through social media sites such as Facebook

McCarthy, M. Experts warn on data security in health and fitness apps. BMJ 347, 57216 (2013). https://search.proquest.com/openview/4b1d76edb55b01a17102dc8a53039eb2/1?pq-origsite=gscholar&cbl=2043523