Mental health apps are under scrutiny for equitable healthcare

Serious fears and complaints of depression, such as a sad mood, avoiding daily activities and re-experiencing unpleasant events. These are all examples of mental complaints. Our mental health plays an important role in our functioning as people, both as individuals and within society. However, there is still a taboo and stigma around the topic, says Caroline Figueroa. “People find it difficult to talk about it, for example because of shyness. While 1 in 5 people will suffer from a mental illness such as depression or an anxiety disorder in their lifetime. They range from mild complaints to serious cases.

Mental health apps

To do something about these complaints, people can seek help from a mental health app. According to Figueroa, such an application could serve different purposes. “For example, an app could give advice on relaxation or breathing exercises. This should prevent complaints from getting worse. But the app could also indicate when someone should contact a specialist. The minimum threshold for using an app is lower than calling a doctor.” General or psychologist.You will not have to deal with long waiting times.

Thousands of applications available

As a researcher, Figueroa looks at the role of technology, such as apps, in preventing or reducing psychological problems as much as possible. “Technological innovation can have a protective effect so that people need fewer treatments in the long term. This is also good for the healthcare sector, where costs are rising dramatically. There are approximately 20,000 mental health apps available worldwide.” The problem is that The quality of these applications is not always good. For example, because the information is not supported by scientific research. User privacy is not always guaranteed. Another problem – and my main concern – is that many of the apps are not comprehensive. This leads to people or groups being excluded, often unconsciously.

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Lack of comprehensiveness

“Non-inclusive” means, for example, that the app is difficult to access for people with little digital skills or a non-Western cultural background. Apps also don’t always take the user’s finances into account when providing advice and guidance. Figueroa: “The problem starts with the psychological research that app developers use as input. Scientists usually only look at a limited target group. The same thing happens when designing an app. App developers often focus on a group that is very similar to them: highly educated, well-income white people. Finally, they tested the app again on this limited group.

App development with young people

Figueroa works on various projects to improve the design of mental health apps for a broader target group. One of these activities – as part of the Sprint Healthy Start project “Coping Mechanisms in Time” – is taking place in the Schildersvik district of The Hague. “In this project, we work with a community center where many young people with migrant backgrounds come. In brainstorming sessions, we ask them about their opinions on mental health apps and what they find important. The idea is to eventually develop a new app together. Through co-creation sessions, The young people themselves developed a number of ideas for designing the application new project We will now also test the use of generative AI as a way to help young people improve their physical and mental health.

Co-creation is important

Figueroa says conversations with young people have yielded some interesting insights. “For me, one of the things that caught my attention was the role of religion. Young people indicated that this could be an important psychological support for them. I personally was not religious, and did not think about this at all. As a researcher, I also have blind spots and biases. This It shows the importance of co-creation. We can integrate religion into the app, for example, by including texts or advice about religion as well. You can also apply this more widely to people who have a different religion or belief.

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Taking care of mental health

Figueroa has worked in the field of mental health for almost her entire research career. This began during her medical studies, where she conducted research on predicting depression based on brain activity. “I noticed that relatively little attention was paid to mental disorders in the study. This is exactly why it appealed to me so much. Especially knowing that it is a widespread societal problem. After earning my doctorate, I began to focus more on the prevention of mental problems. I did more research into This happened while I was a postdoc at UC Berkeley.

Lots of support from motivational messages

The focus of my postdoctoral research was on the use of mental health apps by people in vulnerable situations with depression and diabetes. Figueroa: “I looked specifically at Latinos in the United States, who only speak Spanish, with low socioeconomic status, a group that is barely included in research. This is where I first learned how important co-creation is. In the Schilderswijk project, we developed an app with the target group through co-creation. After the launch, we heard from users that they received a lot of support from the motivational messages they developed in collaboration with the researchers. They felt like someone cared about them, even though they knew That these messages were sent automatically.This research sparked my interest in inclusive design.

Fight for justice

Through her research, Figueroa hopes to remove mental problems from the taboo realm. But what motivates her at least is the aspect of justice. “Everyone has the right to quality health care, both physical and mental. The groups that are often most in need of help are precisely the ones that are not heard or engaged enough. Unfortunately, the issue of inclusivity and justice is still not addressed enough.” In education, science, technology and the world of medicine, I see my mission as changing that. On the one hand, by developing comprehensive apps and also by interacting with stakeholders, such as app developers, researchers and healthcare professionals, to identify and overcome obstacles.

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Conversations with stakeholders

According to Figueroa, such a conversation has several functions. “When it comes to science and technology, I share my thoughts on engaging groups that are typically less involved. Why is this so important? And what is the best way to do it? It would be great if we could eventually develop a series of guidelines for designing inclusive applications, which It also takes into account new developments in the field of artificial intelligence. For example, how can you ensure that there is no bias or discrimination in the algorithms. For healthcare professionals, I try to find out the motives of the insurance company for paying or not paying for a particular application, or the motives of the general practitioner for prescribing Application. So it really requires changes in different areas. That’s challenging, but it also makes it very interesting and fun.”

Megan Vasquez

"Creator. Coffee buff. Internet lover. Organizer. Pop culture geek. Tv fan. Proud foodaholic."

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