Mental Health Mobile Phone App Usage, Concerns, and Benefits Among Psychiatric Outpatients: Comparative Survey Study

Abstract

Background: Despite the popularity of mental health apps, it is unknown if they are actually used by those with mental illness. This study assessed whether differences in clinic setting may influence the use of mental health apps and which factors influence patient perception of apps.

Objective: The objective of this study was to gain an understanding of how individuals with mental illness use their mobile phones by exploring their access to mobile phones and their use of mental health apps.

Methods: A single time point survey study was conducted over a 2-week period in February 2018 at two nearby outpatient psychiatry clinics: one serving largely mood and anxiety disorder patients with private insurance staffed by both faculty and residents and the other serving largely psychotic disorder patients in a state Department of Mental Health (DMH) setting. A total of 25 patients at the state DMH clinic also consented for a single time point observation of apps currently installed on their personal mobile phone.

Results: A total of 113 patients at the private insurance clinic and 73 at the state DMH clinic completed the survey. Those in the private insurance clinic were more likely to download a mental health app compared to the state DMH clinic, but actual rates of reported current app usage were comparable at each clinic, approximately 10%. Verifying current apps on patients' mobile phones at the state DMH clinic confirmed that approximately 10% had mental health apps installed. Patients at both clinics were most concerned about privacy of mental health apps, although those at the state DMH clinic viewed cost savings as the greatest benefit while those at the private clinic reported time as the greatest benefit.

Conclusions: High interest in mental health apps does not automatically translate into high use. Our results of low but similar rates of mental health app use at diverse clinics suggests DMH patients with largely psychotic disorders are as interested and engaged with apps as those in a private insurance clinic treating largely mood and anxiety disorders. Results from our study also highlight the importance of understanding how actual patients are using apps instead of relying on internet-based samples, which often yield higher results due to their likelihood of being selected.

Keywords: apps; depression; digital health; mental health; mobile phone; psychiatry; schizophrenia; smartphone.

Figure 1

Survey.

Figure 2

Mobile phone ownership, app downloads, mental health app downloads, and mental health app use reported by state Department of Mental Health clinic patients.

Figure 3

Mobile phone ownership, app downloads, mental health app downloads, and mental health app use reported by private clinic patients.

Figure 4

Concerns about and benefits of apps in the state and private clinics with (a) concerns and (b) benefits. Statistically significant differences are noted with an asterisk.

Figure 5

Mean count, by app category, of apps on the mobile phones of 25 patients in the state Department of Mental Health clinic. Although mental health apps are included in the health and fitness and medical categories, we added them as a separate category shaded in black for sake of comparison.