Mental Health Mobile App Use to Manage Psychological Difficulties: An Umbrella Review

Purpose: A rapid increase in global smartphone ownership and digital health technologies offers the potential for mobile phone applications to deliver mental health interventions. The purpose of this umbrella review was to bring together evidence reporting on mental health mobile applications to gain an understanding of the quality of current evidence, the positive and adverse effects of applications, and the mechanisms underlying such effects. Design/methodology/approach: A systematic search was carried out across six databases, for any systematic reviews or meta-analyses conducted up to 2020. Review quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR 2). Findings: Across a total of 24 articles, a variety of clinical outcomes were assessed. Most compelling support was shown for applications targeting anxiety symptoms; some evidence favoured the use of applications for depression symptoms. Less evidence was available for the remaining clinical symptoms such as bipolar disorder, schizophrenia, post-traumatic stress disorder, sleep disorders, and substance use. Overall, there was limited evidence pertaining to adverse effects and change mechanisms, and a lack of quality reporting across a large proportion of included reviews. The included reviews demonstrate the need for further robust research before applications are recommended clinically. Originality: This umbrella review makes a valuable contribution to the current status of research and reviews investigating mental health mobile apps. Recommendations are made for improved adherence to review guidelines, to ensure risk of bias is minimised