Dramatic growth in mental-health apps has created a risky industry

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Mental-health apps were designed to be used in addition to clinical care, not in lieu of them. Time to head back to the couch?

Helping people to deal with mental problems has rarely been more urgent. The incidence of depression and anxiety has soared in the pandemic—by more than 25% globally in 2020, according to the, a medical journal. That, combined with more people using online services, has led to a boom in mental-health apps. The American Psychological Association reckons 10,000-20,000 are available for download. But evidence is mounting that privacy risks to users are being ignored.

Underneath, though, a trauma lurks in some corners of the industry. In October 2020 hackers who had breached Vastaamo, a popular Finnish startup, began blackmailing some of its users. Vastaamo required therapists to back up patient notes online but reportedly did not anonymise or encrypt them. Threatening to share details of extramarital affairs and, in some cases, thoughts about paedophilia, on the dark web, the hackers reportedly demanded bitcoin ransoms from some 30,000 patients.

Other cases may arise. No universal standards for storing “emotional data” exist. John Torous of Harvard Medical School, who has reviewed 650 mental-health apps, describes their privacy policies as abysmal. Some share information with advertisers. “When I first joined BetterHelp, I started to see targeted ads with words that I had used on the app to describe my personal experiences,” reports one user.

As for effectiveness, the apps’ methods are notoriously difficult to evaluate. Woebot, for instance, is a chatbot which uses artificial intelligence to reproduce the experience of cognitive behavioural therapy. The product is marketed as clinically validated based in part on a scientific study which concluded that humans can form meaningful bonds with bots. But the study was written by people with financial links to Woebot.

Mental-health apps were designed to be used in addition to clinical care, not in lieu of them. With that in mind, the European Commission is reviewing the field. It is getting ready to promote a new standard that will apply to all health apps. A letter-based scale will rank safety, user friendliness and data security.

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The flip-side to online safety for consumers is the lack of safety of end users within tech companies.

I’m back in the couch for a month now. apps can’t do everything.

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