Smartphones and Mental Health
Like it or not, smartphones are ubiquitous, and here to stay. But how do they affect our mental health?
The answer to this question is mixed.
On the downside, the phenomenon of smartphone addiction is emerging. Smartphone addiction can be described as “excessive and problematic smartphone use”. (https://akjournals.com/view/journals/2006/7/2/article-p252.xml) Typically this emerges in adolescents and young people. The relatively small literature on smartphone use and addiction is divided as to what are the key features. Some researchers find that duration of use is the key marker of addiction. Others find smartphone addiction to be more strongly associated with use frequency than duration. Texting and use of messengers and social media sites were predictors of mobile phone or smartphone addiction (https://akjournals.com/view/journals/2006/4/4/article-p299.xml) . Whatever the markers, excessive usage can occur too much, and occurs to the detriment of other aspects of the user’s life, including higher levels of perceived stress and less satisfaction with life.
On the upside, smartphones can be used as a platform for apps supporting the user’s mental health. There are a wide range of smartphone apps to support mental health (literally hundreds https://mhealth.jmir.org/2020/5/e17798). These include apps that address illnesses such as depression, eating disorder recovery, anxiety, PTSD and obsessive compulsive disorder (https://www.sciencedirect.com/science/article/pii/S2352250X2030052X). Many of these apps incorporate techniques such a cognitive behavioral therapy, acceptance commitment therapy, mood monitoring and mindfulness. Outcomes of some of these apps vary. Some can lead to demonstrated reductions in symptoms of depression and anxiety, and even reduction of suicidal ideation. Other outcomes can be more equivocal (https://mhealth.jmir.org/2020/5/e17798).
Advantages to the use of smartphone apps include their ease of use and wide availability. For many people – especially young people – smartphones are an accepted tool to communicate and using a phone app may feel natural. Apps are also a flexible medium for intervention, and may be tailored for user needs.
In discussing these apps, however, it is important to note some structural and procedural limitations. Unlike many psychiatric and psychological therapies, apps may not be based on rigourous research. Psychiatrists and psychologists may not approve of unregulated technologies replacing evidence-based, face-to-face practice (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/84D2BF70EEA1EAD7E681FF012651B55E/S2056472418000868a.pdf/digital-mental-health-apps-and-the-therapeutic-alliance-initial-review.pdf). Indeed, evidence suggests that these apps work best in conjunction with person-centred therapies (https://www.sciencedirect.com/science/article/pii/S2352250X2030052X). It is also unclear whether some apparently effective apps are really effective or work due to a “digital placebo” effect. There are also challenges related to poor data governance and the possibility of data compromise.
Although it may prove a difficult task, it may be worthwhile for a branch of government to analyse and give feedback upon, or even rate, the plethora of mental health apps that are available on smartphones to best support people who are looking for help.
Dr. Richard Schweizer, Policy Officer at One Door Mental Health richard.schweizer@onedoor.org.au.
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Dr Richard Schweizer