Only half (52 per cent) of mental health smartphone apps that have been rigorously tested in clinical trials are publicly available for download, new Orygen-led research has revealed, highlighting a clear gap between research evidence and availability.
Smartphone mental health apps can address long-standing barriers to traditional care, but the study, published in NPJ Digital Medicine, found no correlation between an app’s proven effectiveness and its availability in app stores, suggesting factors other than effectiveness determine whether an app becomes available to the public.
Senior author and Associate Professor of Digital Mental Health Implementation at Orygen, Jennifer Nicholas, said that while some digital mental health apps have been rigorously trialled and shown to be effective, the quality or strength of the evidence was not associated with which apps made it to market.
“We know that digital mental health tools can be incredibly effective in supporting mental health – and can fill gaps in an overstretched mental health system – but self-guided mental health apps with a solid evidence base are often not translated into readily accessible products, making these supports unavailable for users,” A/Prof. Nicholas said.
The first of its kind systematic review of 110 studies of self-guided apps focused on the translation of research into real-world availability.
“We wanted to understand the factors influencing which mental health apps make it into people’s hands,” A/Prof. Nicholas said.
“The strength or quality of the evidence was not a key factor in whether an app was available to the public, and that should concern anyone who cares about getting effective mental health support to the people who need it."
Lead author and senior VR Research Fellow at Orygen, Dr Imogen Bell, said the results suggested a lack of value placed on evidence by market forces and commercial dynamics.
“This risks undermining the very real potential of digital mental health interventions, which have been proven to be effective in treating range of mental health problems, including depression, anxiety, PTSD, and eating disorders,” Dr Bell said.
“It is vital that we adequately reward and prioritise properly researched and evidence-backed digital mental health tools, and ensure that effective mental health apps make it to the mainstream market.”
The authors noted that the gap between rigorous research and availability reflected failures on multiple fronts.
“It is not just about commercial market dynamics, but also academic and institutional structures that have historically focused on gathering the evidence but aren’t set up to take interventions beyond the laboratory,” A/Prof. Nicholas said.
“Addressing this will require coordinated action from researchers, but also developers, funders, policymakers and marketplaces – to ensure the skills and support for research translation exist, and create clearer pathways for turning effective tools into real-world, available products.”