Cell phone-based support programs

Cell phones, particularly smartphones, offer new opportunities to reach individuals with mental health concerns such as depression, anxiety, post-traumatic stress disorder, and substance abuse. Mobile phone applications (apps) can deliver a form of cognitive behavior therapy, link a user with a medical professional, or allow patients to regularly self-monitor their emotional state and easily share that information with a provider. Texting interventions can include provision of health information, automated reminders, or supportive messages sent to individuals participating in longer term mental health treatment.

Expected Beneficial Outcomes (Rated)

  • Improved mental health

Evidence of Effectiveness

There is some evidence that cell phone-based support programs reduce depression, anxiety, and stress (Donker 2013). Additional evidence is needed to confirm effects and determine which interventions are most effective.

Several mental health mobile applications (apps) appear to improve mental health (Donker 2013). A mobile stress management app, for example, has been shown to decrease anxiety and increase coping skills for oncology nurses and female university students; this app is publicly available in Italian (Donker 2013). An emotion monitoring app may increase emotional self-awareness among adolescents (Reid 2011), indirectly reducing depression over time (Kauer 2012). An effective computer-based cognitive behavioral therapy program for depression appears to remain effective when converted to app format ().

However, research assessing effects of text message-based mental health interventions is limited. Surveys of adolescents and adults suggest that such interventions are acceptable to patients, as long as security and privacy considerations are addressed (, Proudfoot 2010). A small pilot of a text message program for patients with alcohol use disorder and comorbid depression indicates that messages may help to improve mental health and provide motivation to remain sober (Agyapong 2013).

Impact on Disparities

No impact on disparities likely

Implementation Examples

A 2014 review of mental health apps estimates there are more than 3,000 mental health apps available for free or for purchase (Chan 2014). The US Department of Veterans Affairs provides many mobile apps designed for treatment and self-care for veterans and military service members, such as PTSD Coach (VA app). The American Psychiatric Association (APA) provides guidelines for psychiatrists to choose useful, safe, and effective apps (APA-MH app). The Anxiety and Depression Association of America (ADAA) offers reviews and ratings of about 20 mental health apps (ADAA-MH app).

Implementation Resources

APA-MH app - American Psychiatric Association (APA). Mental health apps: Why rate mental health apps?

Citations - Evidence

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Donker 2013 - Donker T, Petrie K, Proudfoot J, et al. Smartphones for smarter delivery of mental health programs. Journal of Medical Internet Research. 2013;15(11):e247.

Watts 2013* - Watts S, Mackenzie A, Thomas C, et al. CBT for depression: a pilot RCT comparing mobile phone vs. computer. BMC Psychiatry. 2013;13(1):49.

Kauer 2012 - Kauer SD, Reid SC, Crooke AHD, et al. Self-monitoring using mobile phones in the early stages of adolescent depression: Randomized controlled trial. Journal of Medical Internet Research. 2012;14(3):e67.

Proudfoot 2010 - Proudfoot J, Parker G, Pavlovic DH, et al. Community attitudes to the appropriation of mobile phones for monitoring and managing depression, anxiety, and stress. Journal of Medical Internet Research. 2010;12(5):e64.

Reid 2011 - Reid SC, Kauer SD, Hearps SJC, et al. A mobile phone application for the assessment and management of youth mental health problems in primary care: A randomised controlled trial. BMC Family Practice. 2011;12(1):131.

Agyapong 2013 - Agyapong VIO, Milnes J, McLoughlin DM, Farren CK. Perception of patients with alcohol use disorder and comorbid depression about the usefulness of supportive text messages. Technology and Health Care. 2013;21(1):31-9.

Ranney 2014* - Ranney ML, Choo EK, Cunningham RM, et al. Acceptability, language, and structure of text message-based behavioral interventions for high-risk adolescent females: A qualitative study. Journal of Adolescent Health. 2014;55(1):33–40.

Citations - Implementation Examples

* Journal subscription may be required for access.

Chan 2014 - Chan SR, Torous J, Hinton L, Yellowlees P. Mobile tele-mental health: Increasing applications and a move to hybrid models of care. Healthcare. 2014;2(2):220-233.

VA app - US Department of Veterans Affairs (VA). VA mobile: VA app store.

APA-MH app - American Psychiatric Association (APA). Mental health apps: Why rate mental health apps?

ADAA-MH app - Anxiety and Depression Association of America (ADAA). Find help: ADAA reviewed mental health apps.

Date Last Updated

Jan 10, 2018