Mental health mobile app use to manage psychological difficulties: an umbrella review

Abstract

Purpose A rapid increase in global smartphone ownership and digital health technologies offers the potential for mobile phone applications (apps) to deliver mental health interventions. The purpose of this paper is to bring together evidence reporting on mental health mobile apps to gain an understanding of the quality of current evidence, the positive and adverse effects of apps and the mechanisms underlying such effects. Design/methodology/approach A systematic search was carried out across six databases, for any systematic reviews or meta-analyses conducted up to 2020. Review quality was assessed using the Assessment of Multiple Systematic Reviews. Findings Across a total of 24 articles, a variety of clinical outcomes were assessed. Most compelling support was shown for apps targeting anxiety symptoms; some evidence favoured the use of apps for depression symptoms. Less evidence was available for the remaining clinical symptoms such as bipolar disorder, schizophrenia, post-traumatic stress disorder, sleep disorders and substance use. Overall, there was limited evidence pertaining to adverse effects and change mechanisms and a lack of quality reporting across a large proportion of included reviews. The included reviews demonstrate the need for further robust research before apps are recommended clinically. Originality/value This paper makes a valuable contribution to the current status of research and reviews investigating mental health mobile apps. Recommendations are made for improved adherence to review guidelines and to ensure risk of bias is minimised.