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Could Mental Health Apps Lead to Overdiagnosis?

In a new Australian study, researchers at the University of Sydney aimed to find out how popular mental health apps tend to portray mental health and what the apps offer in terms of diagnosis and management.

The research team evaluated the advertising materials of 61 popular mental health apps available in the United States, United Kingdom, Canada and Australia during late 2016, focusing on apps that explicitly referenced mental health diagnoses or symptoms and offered diagnosis, guidance or made health claims.

They identified two dominant messages among the apps: poor or fragile mental health is very common, and individuals can easily manage their own mental health problems with apps.

The findings are published in the Annals of Family Medicine.

The study builds on previous work by the University of Sydney’s Charles Perkins Centre’s Evidence, Policy and Influence Collaborative, and was conducted with the University’s School of Pharmacy, Western Sydney Local Health District and University of Adelaide.

The researchers say the findings are cause for concern for a number of reasons.

“Implying mental health problems are present in everyone promotes the medicalization of normal states,” said lead author Dr. Lisa Parker, a postdoctoral research associate with the University of Sydney’s Charles Perkins Centre and School of Pharmacy. “The apps we assessed tended to encourage frequent use and promoted personal responsibility for improvement.”

“The idea that the normal ups and downs of everyday life need treatment could drive use of these apps by people with minor concerns. These users are unlikely to get any significant benefits but may receive large time burdens and potential loss of privacy.”

Parker said it might be beneficial for the app users to hear alternative views about what constitutes normal psychological experiences in order to prevent overdiagnosis.

At the same time, she adds, it could be helpful if people with severe mental health issues hear doctors discuss the limitations of app use as well as the importance of seeking additional forms of supportive health care where needed.

Senior author Dr. Quinn Grundy from the Charles Perkins Centre and Faculty of Pharmacy, agreed that health care professionals have a responsibility to counter some of the messages these apps promote.

“The smartphone is one of the most powerful tools for communication and apps have the potential to increase users’ social supports. Yet popular mental health apps focus largely on individual self-help solutions and personal responsibility. This creates a great deal of silence around external and social factors related to mental health,” Grundy said.

“For people with serious issues, we are concerned the expectation that they can and should manage their mental health problems themselves could effectively deny the need for social supports.”

Parker also expressed concern that the advertising materials tended to portray potential users as employed, white and in a family.

“It’s possible the lack of diversity in representation of users and stressors could alienate people with serious needs,” she says.

Source: University of Sydney



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