People suffering from mental health disorders have traditionally had two options--drum up the resources and courage to seek professional help or cope the best one can.
But technology is changing that, and mobile devices in particular have created a new access point in patient care. Just as apps have enabled people to pursue their physical health goals--by counting calories or inspiring workouts--they can provide a boon to those seeking better emotional health. Why? Apps are inconspicuous and relatively easy to use.
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Everyone's involved in the world of their smartphone or tablet. But whether they're texting a friend, surfing the Internet or monitoring their--or a spouse's-- health, is anyone's guess. For example, there's a small percentage of men with apps who track their partner's menstrual cycle, according to Susannah Fox, associate director of digital strategy for the Pew Research Center's Internet & American Life Project. "If you, for example, are trying to start a family, you need to know when you need to be home," she says.
Exposing new populations to mental health treatment provided the rationale for an app called Anxiety Coach, released last fall by the Mayo Clinic. Using the principles of cognitive behavioral therapy, the app guides users to face their fears and eventually become free of them. Select, for example, "talking in public," and the app provides a to-do list of activities to tackle, such as purposefully mispronouncing a word in conversation or complimenting a stranger.
"You gradually face your fears and learn through your own experience it's unlikely to happen, and when things don't go well, you can handle it," says Stephen Whiteside, director of the Pediatric Anxiety Disorders Program at the Mayo Clinic and co-creator of Anxiety Coach. "People with mild fears could be able to download the app and learn about breaking that cycle of avoidance and be successful with making some improvement on their own." For those who need more support, he adds that the app will "demystify" treatment so people feel more comfortable and empowered to seek help.
Similar reasoning has been used for online treatment in general. Online addiction programs like the one offered by Lionrock Recovery lower the barrier for entry, says CEO Peter Loeb. "Many people now struggling with alcohol and drugs while juggling busy lives don't get help at all because the available options are too costly, too time-consuming and too public," he says.
At the forefront of efforts to provide mental health care via apps is the military.
Reaching a population that's technologically savvy, but reluctant to seek emotional support is what's driving the military's research and development into mobile health apps. The National Center for Telehealth & Technology, also known as T2, which is part of the Department of Defense and the Military Health System, offers nearly a dozen apps on its website that provide current and past members of the military and their families with free, anonymous support. Based on clinical research, the apps are "designed to fill what we call the 'white spaces' in between appointments" or at least provide an entry point into self-awareness that will lead to professional care, says T2 spokesman Joe Jimenez.
They include PTSD Coach, developed with the Department of Veterans Affairs to help service members suffering from post-traumatic stress disorder; T2 Mood Tracker, which lets users record their emotional health, and Breathe2Relax, a stress-management program that Dr. Oz has said he uses for meditation. Thanks in part to Dr. Oz's endorsement, Breathe2Relax is T2's most popular application, having been downloaded nearly 242,000 times by the end of March, Jimenez says.
Tracking the effectiveness of these applications in terms of emotional health and behavior change is harder to determine, experts say. In the case of T2, that's because the apps have only been in use for three years, and the agency has been more focused on producing the apps than holding up the process by developing evaluations.
Meanwhile, T2 and other programs are reporting usage and anecdotal success.
Medhelp--an online health community serving about 12 million users--has an app called Mood Tracker that posts the peaks and valleys of a user's emotional health with elaborate color-coded charts. In one example on the company's website, a patient's management of bipolar disorder is depicted through a variety of indicators (such as loneliness or agitation, work issues and medication), which the program uses to map the person's overall mood.
The app can improve a patient's communication with his or her clinician and, consequently, care, says John de Souza, president and CEO of MedHelp. "The doctors can look at the data very quickly and get creative insights." And for patients, he says, it can help them see the extent of a condition and track the correlation between mood and medication.
For Whiteside, the Anxiety Coach app has proven "more engaging than writing things down" and has made it easier for therapists to monitor their patients. Using these apps not only supplements care but helps to fill a void between supply and demand in mental health care, where there's a dearth of mental health professionals, Whiteside says. "Only about 30 percent of the people who have anxiety disorders actually get help," he says. "Hopefully, we can use technology like Anxiety Coach to get help to the people who need it in the most effective way."