TOPLINE:

More than 1 year after the national rollout of the 988 Suicide and Crisis Lifeline, only 15% of mental health mobile apps incorporated this national standard hotline for crisis support, a new study showed. Additionally, 14 apps with more than 3.5 million downloads provided incorrect or nonfunctional alternative crisis hotlines, highlighting the importance of thorough screening and regular developer updates, the investigators wrote.

METHODOLOGY:

• The cross-sectional study included a comprehensive search of mental health apps using the M-Health Index and Navigation Database and app marketplaces. Researchers collected a representative sample of 302 mental health apps available for download to mobile phones in January 2024.
• Eight trained and experienced app raters, all demonstrating good interrater reliability, participated in the evaluation.
• Of the evaluated apps, 96% were available to download from the Apple App Store and 74% from the Google Play Store; 41% were completely free, and 59% required payment for full use.
• The raters also assessed the apps for the presence of the 988 hotline and searched for alternative crisis resources within the app.

TAKEAWAY:

• Among the 302 evaluated apps, only 134 had been updated in the previous year; 217 apps lacked any form of crisis hotline or resource contact information.
• Among the 44 apps that included 988 crisis information, 55% embedded a link for a direct connection to the hotline, and 48% redirected users from the app to the 988 website.
• Of the 10 apps that focused on self-harm, only two mentioned the 988 hotline directly.
• Among the 71 apps that included alternative crisis hotlines, 85% offered call-based services and 39% provided hotlines with text or chat features. Additionally, 99% connected users to a human, and 1% connected them to an artificial intelligence chatbot.

IN PRACTICE:

“Although mental health apps have great potential for elevating mental health care, their capacity to offer support during crises remains limited,” the investigators wrote. 

“To improve hotline accessibility to all users, mental health app regulators should consider the ubiquitous implementation of 988 and regular evaluation of the hotlines included in these apps,” they added.

SOURCE:

The study was led by Bridget Dwyer, Beth Israel Deaconess Medical Center, Boston. It was published online on August 21 in Psychiatric Services.

LIMITATIONS:

The study assessed the functionality and immediate display of crisis resources but did not analyze resource content in depth. Not all mental health apps available to download on Apple App Store and Google Play Store were included. Additionally, the study focused solely on mental health research trends in the US, limiting its cross-cultural generalizability.

DISCLOSURES:

One investigator reported receiving past research support from Otsuka and serving as a clinical adviser to Boehringer Ingelheim. The other researchers reported having no relevant financial disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.