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If you go to the App Store on your iPhone and type “depression” into the search bar, you’ll find dozens of apps purporting to screen for or help alleviate depression. One study claims there are 10,000 such apps, another some 350 or so.
Depression is a problem. The World Health Organisation calls it one of the “leading causes of disability” worldwide, and says there are 260 million sufferers — about one in every 30 people globally. The number of sufferers has gone up by about 50% since 1990, according to the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, although since the global population has also increased by about the same percentage in that time, the prevalence hasn’t really changed. If we look at all mental health issues together, almost a billion people — more than one person in eight — are affected.
This is a serious burden, whether or not it is getting worse. But it goes largely untreated. The same WHO article says that between 76% and 85% of people with depression in developing countries receive no help (although they base this claim on data from 2007 so it may be outdated). In the developed West, of course, the figures are less — but still, here in Britain we are facing an NHS funding shortfall, and not everything that we would like to fund can be funded. It’s against that background that we see the proliferation of depression-treatment apps.
In theory, at least, an app doesn’t need a doctor, or an appointment; it’s fast and scalable and cheap. So if you can farm out a decent fraction of treatment to them, then you’ll provide a huge amount of benefit to a large swath of society, and save the NHS millions as you do so.
The trouble is that there doesn’t seem to be a great deal of evidence that they actually work.
A study from November last year looked at 293 mental health apps and found that only 3.41% — that is, ten of them (!) — even claimed (!) to have evidence showing their effectiveness. Of those 10, only three were backed by independent research, i.e. research not carried out by the people who made it.
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