Can we really tackle mental health issues with apps?


Geoff Simons posed this question recently to a LinkedIn group for UK Therapists in Private Practice, in response to the following article: ‘Could Digital Health Save the Mental Health Epidemic?’, published in the Huffington Post.
Initial responses indicate a variety of responses. It may be worth considering this in more detail.
On the one hand, we have increasing numbers of mental health and therapy services being delivered very effectively online, both by organisations and individuals. Some inspired researchers, trainers and practitioners have spent considerable time and money exploring ways in which we can embrace technology in order that many more people have access to psychological support and mental healthcare than can be helped within existing face-to-face services. This makes financial sense and also ensures that such provision acknowledges and engages with sociological changes that are resulting at a frightening speed from the technological revolution of the late twentieth and early twenty-first century. This feels both progressive and highly effective.
On the other hand, we are also becoming increasingly aware that technology itself is rapidly changing the way we think, communicate and respond emotionally to situations and to each other and that new and different psychological challenges and significant difficulties are arising as a result of these changes. We know that young people, in particular, are experiencing more and more mental health difficulties and are feeling more stressed than previous generations, partly as a result of changing behaviours and expectations that arise from technology.
Technological progress will not cease and, as psychological therapists we must surely work with it, to make the best of it.  The challenge to us all is to identify the elements that are life-enhancing and maintain wellbeing and to embrace these things whilst simultaneously holding in mind the very real possibility that the technology we are employing may be triggering the human difficulties we are trying to manage and lessen. Our need for ‘instant gratification’, which indeed may be met by an app, has been studied at length by psychologists, who have demonstrated through research studies that those who can tolerate more delayed gratification tend to go on to manage their lives more effectively and successfully in all kinds of areas.  Is it possible that some technological approaches to mental health provision and ‘apps’ in particular may be encouraging an expectation of a ‘quick fix’ (or instant gratification)? May they also be increasing the expectation that we can use the technology as a substitute for human interaction? Loneliness and social anxiety are problems that young people describe as frequent and significant within our technological world.
We need to pay close attention to the way in which a programme or a piece of software is marketed and promoted, and should perhaps be particularly wary of those which make claims to be able to effect rapid change when used in isolation from any other therapeutic input. We know that effective therapeutic change is often slow, difficult and requires courage, determination and patience. The speed of technological progress is perhaps sometimes at odds with the less rapidly changing pace of human evolution. It is certainly worth bearing this in mind and encouraging software developers to take care with their products and their marketing.  The article mentions a website My Health Apps, where significant numbers of health-related apps are identified and reviewed, including many offering mental health support. We might consider how many of these appear to claim to offer a substitute for human interaction. Some apps undoubtedly contain wonderful and sophisticated tools, but we should remember too that the therapeutic relationship between client and therapist has been shown time and time again to be the most significant factor in effecting change, and that relationships take time to develop.
Kate Dunn, January 2017