On the Digital Couch.

Mental Health

Is the increasing number of ‘wellness apps’, ‘mindfulness apps’, or ‘counselling apps’ worrisome, or do they actually work?

As per a recent PwC report, mHealth or Mobile Health platforms are the future of Indian Medicine, wherein most diagnoses will be carried in a mobile device with a small additional attachment that can be bought from your local pharmacy. However, when it comes to mental health, we have reasons to believe that the future the report speaks of is already here. Given the stigma that mental health illness and its patients face in this country, it is not surprising to see that instead of properly trained psychologists and counsellors, we are turning to our mobile phones and the internet. And for a country like ours which has just recently started taking mental health with a little degree of seriousness, counselling apps tend to provide a point of entry into a still evolving, but thriving healthcare system.

Given the current lot of such apps, it seems that we need to be a little cautious. Mainly because one of the key elements when dealing with mental health, the human presence, is done away with because of these apps. Speaking on the importance of a properly trained counsellor at the beginning of the process, Pooja Nair, a psychotherapist practising in Mumbai says, “From the perspective of a client, not a patient, beginning the journey of healing and growth with a therapist would be of great value. A human’s touch offers much-needed validation and hope. The counsellor also has the advantage of responding to the individuality and uniqueness that each client brings with them, something an app is inadequate in.”  However, Sonia Puar, a professor in Clinical Psychology at Amity University believes that these apps are a great place to begin with. She says, “These apps inform the clients to seek help from professionals, if and when required. Self-management is the beginning of at least acknowledging that you need to change something, that there is something wrong, and this is what these apps are aimed at doing.”

Why exactly do counsellors recommend this app though? Nair believes that there are some key advantages that these apps offer over a conventional counselling session. “They can be accessed from the privacy of their homes, offices etc. Plus it's instant - a therapist can be available to a client only once a week, for an hour. And it's less expensive for sure. Some of these apps can be accessed for free. Therefore, it's convenient, private, and not prohibitively expensive, capable of addressing the immediacy of the distress.” Dr Gaurav Deka, a practising psychotherapist believes that even though these apps are not capable of dissecting, analysing and deciphering a mental health or an emotional health issue, they are great in accentuating or boosting the process of healing. He also believes that these apps are great for cases where medications are not necessary. “I am faced with so much of opposition, confusion, and sometimes doubt when I tell people that drugless therapy is possible - that their depression can go, that their anxiety or OCD can be eliminated.”

However, there are certain things one needs to be wary of. Dr Deka raised an issue that pertains to people’s behaviour when seeking treatment. He says – “These apps may even be dangerous at some point because most people are looking for either a diagnosis or a quick escape, either of the two when they start using these apps on their own.” Nair raises another valid question regarding the ethics of these apps. “Some of the red flags in the use of apps are about data privacy, confidentiality, lack of accountability in an already unregulated sector (that of mental health). How is one to ensure that ethical protocols will be followed, accountability maintained, and that counsellors available on such apps are properly and regularly properly trained?”

Professor Puar, though is completely confident of these apps. “The first step is education about the illness, and understanding of symptoms,” she says. “A detailed and comprehensive approach to such issues will only follow when a basic understanding is established. And this is what these apps help in achieving.”

It seems that such apps do work, but only when used in conjunction with a properly trained counsellor. Depending on the app alone is not feasible, as of yet. Dr Deka says “With a good AI app, certain cases may be taken care of. But for that, I feel the perfect and a wholesome algorithm is yet to be discovered.” He says he has often recommended apps like Headspace, Insight Timer, and Hear and Now to several of his patients, but only after explaining to them their issues, and the root of those issues. “However taking away a human therapist or replacing one is not something I am in for – at least for the next ten years.”