Young adults’ perspectives on using smartphone apps for bipolar disorder self-management

Early intervention is critical to improving the quality of life of people with bipolar disorder and preventing the development of secondary morbidities. Those living well with the disorder champion the role of active self-management in the control of this chronic episodic condition. Novel approaches to support self-management using smartphones have recently been explored. However, insights into consumer perspectives regarding how mobile health (mHealth) can best support disorder management are lacking. This thesis sought to address this gap by examining consumers’ perspectives on mHealth and self-management for bipolar disorder, particularly in young people. The thesis examined four objectives across three studies, resulting in four published papers. Study 1 used a mixed-methods online survey to examine what young people with bipolar disorder currently do to manage their mental health and their thoughts about the potential use of smartphone apps for this purpose. Study 2 adapted a systematic review methodology to assess the features, functions, and quality of available apps for bipolar disorder. Study 3 employed a qualitative methodology to examine data from app store reviews to understand what users of bipolar disorder apps thought of them. Results indicated that young adult participants underutilised clinically important self-management strategies such as symptom monitoring and stay-well planning. Forty percent of participants already used disorder management apps and 79% of those who did not, indicated interest. Participants were interested in apps to support an average of 14 self-management practices. In contrast, available apps for the disorder only perform a few functions. Further, evaluated apps were found to be poor quality, based on their fidelity to evidence-based practice. App store reviews indicated that many users use apps to support clinical care. Whilst most users were positive about disorder management apps, particularly apps perceived to be helpful and easy to use; the number of feature requests suggests current resources do not adequately meet consumer needs. Thesis results highlight the features and functions of disorder management apps that are important to consumers. This information can guide the development of consumer-focused evidence-based apps to support self-management in early stage bipolar disorder. Critically, a diversification of app capabilities is required to fulfil the full potential of disorder management apps