Welcome to the forum! Thanks so much for taking the time to dig into this question and sharing your findings. The treatment gap in global mental health is enormous and apps are an essential tool for addressing this challenge.
I didn’t have time to review your calculations in detail, but I have a few general reflections that may be useful.
1) There is a brand new meta-analysis on the efficacy of mental health apps which includes 176 RCTS (Linardon et al, 2024). They conclude that “apps have overall small but significant effects on symptoms of depression and generalized anxiety, and that specific features of apps – such as CBT or mood monitoring features and chatbot technology – are associated with larger effect sizes.”
2) There is a substantial difference in efficacy between self-help and guided self-help apps. Kaya Guides (incubated by Charity Entrepreneurship) is using WhatsApp to pilot the WHO’s guided self-help intervention in India. Their founder wrote an excellent summary of their work here.
3) Be careful with using a single WELLBY number for AMF. The wellbeing effects of life-extending interventions vary widely depending on philosophical choices, so it is better to use the range of possible outcomes rather than a single figure (see The Elephant in the Bednet).
4) John Torous is a leading researcher and thought leader in digital mental health. If you’d like to spend more time learning about this topic, I recommend looking at his recent publications.
5) The current market for mental health apps is completely unregulated and there are major concerns about privacy and data protection. Wellcome recently awarded £1.8m to MHRA and NICE to explore how the market could be regulated more effectively to protect patient safety.
Thank you for finding that update to Linardon, that looks very useful & I can pretty easily incorporate it. Will do ASAP and update the OP.
Guided self-help is interesting, of course, as a related flavour. I am much less familiar with the mechanics and cost structures. I suppose I also have general moral qualms about interventions that rely on low-cost labour to reach cost-effectiveness, but that’s a post for another day.
Yep, aware of Elephant in the Bednet. I deliberately chose the highest estimate of cost-effectiveness I could find for steelpersoning purposes, but for just evaluating cost-effectiveness head-to-head it would be inappropriate.
Will go through Torous’ work—thank you for the recommendation!
Yeah, I am very concerned about that aspect of the current market and a few other papers I reviewed suggested numbers in the range of 30% of users made download decisions based on privacy. I think there’s a lot here!
Thank you again, particularly for the extra research directions. Will analyse further :)
Welcome to the forum! Thanks so much for taking the time to dig into this question and sharing your findings. The treatment gap in global mental health is enormous and apps are an essential tool for addressing this challenge.
I didn’t have time to review your calculations in detail, but I have a few general reflections that may be useful.
1) There is a brand new meta-analysis on the efficacy of mental health apps which includes 176 RCTS (Linardon et al, 2024). They conclude that “apps have overall small but significant effects on symptoms of depression and generalized anxiety, and that specific features of apps – such as CBT or mood monitoring features and chatbot technology – are associated with larger effect sizes.”
2) There is a substantial difference in efficacy between self-help and guided self-help apps. Kaya Guides (incubated by Charity Entrepreneurship) is using WhatsApp to pilot the WHO’s guided self-help intervention in India. Their founder wrote an excellent summary of their work here.
3) Be careful with using a single WELLBY number for AMF. The wellbeing effects of life-extending interventions vary widely depending on philosophical choices, so it is better to use the range of possible outcomes rather than a single figure (see The Elephant in the Bednet).
4) John Torous is a leading researcher and thought leader in digital mental health. If you’d like to spend more time learning about this topic, I recommend looking at his recent publications.
5) The current market for mental health apps is completely unregulated and there are major concerns about privacy and data protection. Wellcome recently awarded £1.8m to MHRA and NICE to explore how the market could be regulated more effectively to protect patient safety.
Cheers Barry!
Thank you for finding that update to Linardon, that looks very useful & I can pretty easily incorporate it. Will do ASAP and update the OP.
Guided self-help is interesting, of course, as a related flavour. I am much less familiar with the mechanics and cost structures. I suppose I also have general moral qualms about interventions that rely on low-cost labour to reach cost-effectiveness, but that’s a post for another day.
Yep, aware of Elephant in the Bednet. I deliberately chose the highest estimate of cost-effectiveness I could find for steelpersoning purposes, but for just evaluating cost-effectiveness head-to-head it would be inappropriate.
Will go through Torous’ work—thank you for the recommendation!
Yeah, I am very concerned about that aspect of the current market and a few other papers I reviewed suggested numbers in the range of 30% of users made download decisions based on privacy. I think there’s a lot here!
Thank you again, particularly for the extra research directions. Will analyse further :)