Can mobile phone apps support our teens’ mental health?
For some of us, being an adolescent was quite some time ago and for others, it’s been a more recent experience. Nevertheless, there is no denying that teens today are digital natives where most are “thoroughly engaged” as they would put it, with mobile phone technology. There is no doubt that a portion of society perceive mobile phone technology and even some apps in a negative light. However, what if our teens’ engagement with mobile phone apps could provide a gateway to better supporting youth mental health? A study by Grist, Porter, and Stallard (2017), estimated that the majority of children and adolescents in 2017 use a mobile phone (72% of children aged 0-11 years and 96% of those aged 12-17 years), suggesting the ease of accessibility for adolescents to utilise mobile phone apps as a resource to potentially support their mental health.
The current context of adolescent mental health is riddled with various issues of concern. A Youth Mental Health Report evaluated the mental health risks and prevalence of youth from 2012 to 2016 (Mission Australia in association with Black Dog Institute, 2016). The report noted that one in four young people are at risk of having a serious mental illness and that risk tends to increase as adolescents age. The report also highlighted that young people seek help reluctantly. This is important to consider when we already know that typically, the period of adolescence is characterised, by teens seeking a greater degree of autonomy and independence. With this in mind, it’s no surprise adolescents have a greater desire for privacy and withdrawal of help seeking behaviours such as asking others for mental health support or self-referring to a counsellor. As a result, those with higher levels of risk of mental health problems are more likely to seek help online, suggesting that stigma and fear of being judged continue to inhibit help-seeking. With this background in mind, one of the seven key policy recommendations from the report include the use of technology which provides an alternative to face-to face service delivery (Mission Australia in association with Black Dog Institute, 2016).

In addition, an interview with a NSW Department of Education (DOE) School Counsellor, (let’s use the pseudo name Rebecca), highlighted some of the benefits of the use of mental health apps noting that “It is one of the interventions (she) can recommend with the strongest uptake. Teens are glued to their phones and are more likely to engage with a strategy if they can access it on their phone,” (Rebecca, personal communication, August 11, 2020). She goes on to explain how she finds it helpful as a psychologist in the school environment to be able to offer students some resources to take away from session as “I am often not able to see them regularly.” In addition to this, when asked why she thinks teens are in favour of using apps as oppose to seeing the school counsellor she noted “I think students are often hesitant to see the school counsellor due to the stigma that can be attached to help seeking. I also think students have had negative experiences with previous counsellors which can make them less likely to reach out for help. Teens may prefer the use of apps as no one else needs to know that they are struggling. Some senior students prefer to use apps as it does not take out of their class time,” (Rebecca, personal communication, August 11, 2020).
Similarly, a study by Punukollu et al. (2020) evaluated the perceived benefits of mental health apps of which 2320 pupils (aged 11 to 14 years) and 90 teachers were included. The study identified that mental health app use benefited students and staff in terms of high pupil engagement and assisted teachers in reducing the stigma of mental health support. It is quite clear that in reality, apps have proved to be a useful resource in supporting teens’ mental health.
While Rebecca describes the usefulness of apps throughout her counselling practice, a review of mental health apps by the World Health Organisation (WHO) found more than 1536 apps for depression, but only 32 were associated with published articles raising a concern that these apps may not necessarily reflect evidence-based treatment guidelines (as cited in Grist et al., 2017; Rebecca, personal communication, August 11, 2020). Another issue in evaluating whether apps can be used as a resource to support teens’ mental health is whether teens will actually use these apps. A study by Grist, Cliffe, Denne, Croker, and Stallard (2018) aimed to identify whether young adolescent girls would actually be open to using such apps. The study administered a survey to 775 girls (aged 11–16 years) and found that while 97.4% of girls used mobile phone apps, only 6% had used apps with a focus on mental health purposes. The study also identified that out of the girls who indicated that currently had mental health symptoms, 15–17% used or were using a mental health app, with only 48.5% reporting that they would not use a mental health app. While the study did not indicate reasons as to why there was a reported lack of willingness to engage in the use of such apps, it is important to evaluate risks and barriers associated with the engagement of mental health apps. School Counsellor, Rebecca recommends that “Apps need to be clearly explained to students to ensure they are not being used as a replacement for personalised psychotherapy.” She notes that “of course, there is always a risk that students will do research on apps themselves and use ones that are not helpful or even counterproductive to improving their mental health,” (Rebecca, personal communication, August 11, 2020).
In evaluating mental health apps as a resource to support adolescent mental health. it is important to identify reasons for why teens’ may not engage with them. A study by Povey et al. (2016) evaluated the usefulness of two mental health apps; the AIMhi Stay Strong app and the ibobbly suicide prevention app which are both designed to support mental health of Aboriginal and Torres Strait Islander communities.

Mobile phone app developers may want to look at how to design their apps with these factors in mind to increase the engagement of adolescents and better support their mental health. While research is limited in evaluating these factors Grist et al. (2017) suggest that apps need to provide immediate support, anonymity, tailored content, lower cost and present favourable opportunities for adolescent engagement in these apps as a resource to support their mental health. Rebecca (NSW DOE School Counsellor) shared some recommendations she has of the following apps which she has found quite useful in supporting her adolescent-aged clients’ mental health (Rebecca, personal communication, August 11, 2020).

Lastly, despite studies indicating lower than expected
willingness to engage with mental health apps, there is no doubt that
practitioners have found apps as a useful alternative resource. In light of the
current COVID-19 pandemic online tele-health platforms have been utilised in
lieu of face-to-face service delivery. NSW DOE School Counsellor employees for
example, have been encouraged to use an online tele-health platform for their
remote counselling sessions. Given the
encouragement to use tele-health services in lieu of face to face counselling
sessions and the current pandemic limitations in face to face service accessibility,
one may wonder, “Why not use mental health apps too?”
- Written by Natalie
Shamir
References
Grist, R., Porter, J., & Stallard, P. (2017). Mental health mobile apps for preadolescents and adolescents: A systematic review. Journal of Medical Internet Research, 19(5), 153–166. https://doi-org.ezproxy.uow.edu.au/10.2196/jmir.7332
Grist, R., Cliffe, B., Denne, M., Croker, A., & Stallard, P. (2018). An online survey of young adolescent girls’ use of the internet and smartphone apps for mental health support. BJPsych Open, 4(4), 302–306. https://doi-org.ezproxy.uow.edu.au/10.1192/bjo.2018.43
Mission Australia in association with Black Dog Insititute. (2016). Youth mental health report: Youth survey 2012-2016. Retrieved from http://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/2017-youth-mental-health-report_mission-australia-and-black-dog-institute.pdf?sfvrsn=6
Perkins. M. (2012). Canva. https://www.canva.com/en_au/
Povey, J., Mills, P. P. J. R., Dingwall, K. M., Lowell, A., Singer, J., Rotumah, D., Bennett-Levy, J., & Nagel, T. (2016). Acceptability of mental health apps for Aboriginal and Torres Strait Islander Australians: A qualitative study. Journal of Medical Internet Research, 18(3).
Punukollu, M., Leighton, E. L., Brooks, A. F., Heron, S., Mitchell, F., Regener, P., Karagiorgou, O., Bell, C., Gilmour, M., Moya, N., Sharpe, H., & Minnis, H. (2020). Safespot: An innovative app and mental health support package for scottish schools – a qualitative analysis as part of a mixed methods study. Child and Adolescent Mental Health. https://doi-org.ezproxy.uow.edu.au/10.1111/camh.12375









