Self-help apps not a proxy for therapy

A recent National Mental Health survey indicated that one in twenty adults may be suffering from clinical depression in India. Yet, many are hesitant to get the help needed. “There is a lot of stigma associated with depression and other mental health illnesses. As a result, many people are afraid of even letting their loved ones know that they need help,” explains Dr Rizwana Begum, psychological counsellor and psychotherapist with Aviva Clinic.

Lack of mental health services, along with a lack of awareness, has also created a huge gap between those in need and those offering help. Realising this gap, many companies have tried to create online platforms where people can seek the help they need. If one types in the word ‘depression’ on to the Google Play app, more than 250 mobile applications will appear, promising to cater to those struggling with depressive symptoms. 

Apps an alternative to therapy?

Self-help apps are not a substitute for therapy, shares Dr Begum. “Human touch is very integral to psychology and therapy. An app can give information, but it cannot replace human help. They may be helpful to some extent, but it can never be used as the sole form of treatment,” she adds. While they might be able to provide users with the tools to manage mental health symptoms, professional consultation is the safest way to evaluate and manage one’s mental health concern.

A study conducted by researchers at the National Institute of Mental Health and Neuro Sciences (NIMHANS) on free self-help apps for depression available on play store found that these portals are not of uniform quality. It is very important for users to be aware of the scope and limitations of these apps as well as have an understanding of the nature of one’s mental health issue if they were to use an app, the study says.

200 plus apps were screened based on their content and nature and only interactive apps were further reviewed in depth. The researchers found 33 such apps, that allowed users to interact in some way, such as answering a survey, getting feedback and recording thoughts or plans.

“Interactive self-care apps are those which have elements that require users to become more actively engaged with the app components,” explains a doctor at NIMHANS.

The study, published in the Asian Journal of Psychiatry, further examined the apps in terms of guidance provided to users. The parameters that the study authors used to review the apps included advice given to users to help make decisions about using the app, its ability to guide users to seek professional help if needed, guidance about dealing with a crisis, and the range of therapeutic strategies utilised. It was concluded that less than ten per cent of these apps explicitly delineated their scope or included initial screening. Guidance regarding managing suicidal crisis was incorporated in only about 12 per cent of the interactive apps.

“Apps that have standalone screening tools can be useful, provided these contain standardised tools and guide the users at the end of the assessment. Similarly, apps that provide suggestions on coping with depression can also have some utility in terms of improving knowledge or mental health literacy. How useful these are, depends on the quality and accuracy of the content provided,” she explains.

For those will low or mild severity depressive and anxiety symptoms, these interactive self-help apps can be useful as a supplement to professional help as long as they are well structured, she adds. 

NIMHANS own app

The mental health institute used the information from the study to help develop PUSH-D (Practice and Use Self-Help for Depression), a self-care program for individuals with mild or low levels of depressive symptoms.

The programme is accessible in browser-based, as well as app-based formats. The users have to complete an initial screening to help determine whether the program is suitable for them. In case a person’s depression is at higher levels or has more than one mental health problem, the app advises one to seek treatments under the direct care of mental health professional. 

Some helpful apps

Depression CBT Self-help guide

Mood Tools- Depression

Pacifica

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