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Despite enthusiasm for digital technology in addressing young people’s mental health, few effective apps have been successfully rolled out.

Young girl using her mobile phone © Tom Hull

Researchers from Oxford University examined information from 34 studies into the effectiveness of a total of 29 mental health apps for young people (those aged between 15 and 24).

Of the 29 apps that were evaluated, only eight were existing, commercially available mental health apps.

The remaining 21 apps were newly developed, but fewer than half (only nine out of 21) of those were publicly available, either commercially or otherwise, such as in mental health services.

Dr Holly Bear, postdoctoral researcher from the University of Oxford, said:

“Given the widespread ownership of smartphones, apps could potentially address current issues facing service provision in youth mental health, being both affordable and able to be rolled out to large numbers of people. 

“So we were surprised that less than half of the mental health apps that have been shown to be effective are used after studies are finished. This raises concerns that more needs to be done to take these interventions to the next stage of dissemination and close the research to practice gap.”

The authors looked at how useful, feasible and engaging the apps were and identified possible barriers to preventing the apps being implemented more widely.

These included the lengthy processes of applying for funding and app development, with funding often harder to secure for follow-on implementation research than for the initial evaluation, despite being essential to making the apps available to the public.

The report concludes that studies testing the effectiveness of apps should ensure they are planning for implementation from the beginning, and should build collaborations with partners already working in the field (academic and commercial) to capitalise on existing knowledge and digital technology.

The paper also showed that most of the studies were conducted using very small samples of people.

Mina Fazel, Professor of Adolescent Psychiatry at the University of Oxford and the senior author of the review, said:

“These findings highlighted that the evidence-base for effective mental health apps for adolescent populations is still very small with the majority of studies being conducted on less than 100 participants.

“Taking effective apps to the next stage and ensuring they are then rolled-out is still a slow step in the research to practice cycle. This is why we need a renewed focus on implementation to better reach the populations that could benefit from interventions that we know might help.” 

Ed Watkins, Professor of Experimental and Applied Psychology at the University of Exeter and lead of the Horizon2020 ECoWeB project underpinning this research, said: “This review reveals the mismatch between evidence for efficacy of mental health apps and their implementation. Commercially available apps don’t always have a strong evidence-base and apps emerging from academic research often don’t end up being implemented.

"Greater attention and resources for implementation at all stages would increase the benefit of apps for those who could gain from digital interventions.”

The project received funding from the European Union’s Horizon 2020 research and innovation programme and has been published in the Journal of Medical Internet Research.