Thérapie digitale : quand le numérique se préoccupe de votre santé mentale

The government is investing in the health of French citizens:

The Grand Challenge “Digital Medical Devices in Mental Health” aims to support the emergence of innovative digital health technologies in mental health and psychiatry. Its action plan was made public on June 18, 2024.

Initially implemented during the Covid-19 pandemic, this initiative represents a major public health issue. What digital levers are being deployed in the field of mental health, and what pitfalls should be avoided?

Mental health: preliminary definition and overview

Definition

The notion of mental health defined by the WHO (World Health Organization) includes two main meanings:

• Mental health is a “state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to the community.”
• “Mental health is a state that fluctuates throughout life depending on external factors […] but also more personal factors […]. It is therefore a resource that can deteriorate due to repeated exposure to socio-environmental factors.”

Overview

Anxiety, major depressive disorders, schizophrenia, and bipolar disorders: these conditions each require different types of support.

France’s public health agency identifies three major areas for prevention and promotion of mental health:

• “Promote well-being and prevent disorders,
• Identify and orient patients early so that disorders do not become established, worsen, and become chronic,
• Improve the quality of life of people with disorders.”

New technologies have enabled the emergence of digital innovations in the field of mental health. They allow professionals, through certain algorithms, to develop and offer personalized treatments tailored to the issues faced by individuals with mental health disorders. This mainly involves analyzing data collected through dedicated applications available on electronic devices (smartphones, smartwatches…).

A typology of applications

To find your way around, here are the four main types of applications in this field:

Mindfulness and meditation

• Example apps: Headspace, Calm
• Objectives: Reduce stress, improve mental well-being
• Methods:
  • Relaxation practices
  • Guided meditation exercises
  • Breathing exercises

Self-help and cognitive-behavioral therapy (CBT)

• Example apps: MoodKit, Sanvello, Happify
• Objective: Deconstruct negative thought patterns and behaviors
• Methods:
  • Identify problematic thoughts and behaviors
  • Understand their origin and impact
  • Restructure these patterns to promote a more positive mindset

Mood and symptom tracking

• Example apps: Moodfit, Verywell Mind, Daylio, Mood Tools
• Objectives: Increase emotional awareness, detect mood variations
• Methods:
  • Monitor and record emotions and daily mood

Access to professionals and peers

• Example apps: TalkLife, Peer Collective, HeyPeers
• Objective: Provide a space for sharing and emotional support
• Methods:
  • Connecting users with a community of individuals with similar experiences
  • Access to specialized counselors

Data extracted from the article “Digital technology and mental health: the boom of mobile applications” (Alcimed)

The contributions of digital applications to mental health

At what stage of the patient journey can these applications intervene? In the field of telehealth (or remote therapy), they help personalize treatments, delivered as exercises, using biomarkers. These are biological characteristics that make it possible to verify whether a disease appears or progresses in a patient. A biomarker also measures the effects of a treatment.

According to the French Health Insurance website (CPAM), telehealth or remote therapy has several objectives: prevention, diagnosis, treatment/healing, follow-up/support.

These applications are characterized by ease of use, discretion, and lack of stigma—no one is judged. They make communication easier and provide personalized care. For example, some people have limited access to care because they are isolated and cannot travel to a doctor.

Another example: the SIMPLe+ app, deployed in a Franco-Spanish research program on mental health. It offers people with bipolar disorder support addressing their difficulties through two approaches: psychoeducation and self-assessment. The starting point for using the app is the user’s mood variations. They can track sleep, energy, irritability, and treatment—data that then allows them to receive personalized psychoeducational advice.

The limits of applications dedicated to mental health

Despite the enthusiasm around these applications and the strong need for diverse support in mental health, these digital tools are not a cure-all. There are four points that users must be particularly vigilant about:

1. Because information about the effects of these applications is incomplete, it is difficult to measure their reliability and effectiveness.

2. Applications do not replace therapy provided by licensed professionals, whose expertise cannot be substituted. Professional monitoring is also lacking.

3. Cyberattacks call for vigilance online. However, older people or those with disabilities remain vulnerable to cybercrime.

4. Companies that own these apps may misuse private data: confidentiality and security therefore raise real concerns.

As the WHO reminds us, e-health is defined as “digital services in the service of individual well-being.” However, some apps’ privacy policies are vague, and the data collected may be shared with third parties, even though this is unethical and illegal (such as under the General Data Protection Regulation).

Finally, it is essential to highlight that while a practitioner can be criticized for offering an “illusory or insufficiently tested remedy or procedure” (Art. R.4127-39 of the French Public Health Code), the risk is multiplied for applications developed by businesses. Developing and promoting mental health apps is expensive and relies on substantial marketing… which requires profitability and return on investment. Effectiveness does not always live up to the claims.

Recommendations

Before downloading an application

• Research information about data security and the app’s reliability.

• Download these applications from official stores such as the App Store and Google Play.

• Review the app’s privacy policy before installing it on your device. More generally, be mindful of the data you share online.

• In the health field (especially mental health), be cautious with free applications.

For the apps you have downloaded and use regularly

• Some request permanent access to your location:
  • adjust your phone settings to prevent your position from being constantly shared with third-party services. The same applies to other permissions: a mental health app does not necessarily need access to your camera or contacts, for example.
• Update these applications regularly to prevent hacking.
• Use an email address and a complex password to protect your confidential information.
• Delete applications you no longer use.

In mental health, an application does not replace a healthcare professional. These digital tools offer potentially valuable features but still require thoughtful and responsible use.

References:

• DREES.gouv.fr – Health expenditure in 2023 – Health accounts results – 2024 edition
• Santé.fr – Mental health prevention
• WHO – Mental disorders
• Alcimed – Digital technology and mental health: the boom in mobile applications
• SIMPLe+ France – Bipolar disorders
• JDN – How mental health apps threaten our privacy
• France 2030 – Developing and producing tomorrow’s medical devices
• CNIL – Mobile health apps and personal data protection: key questions to ask yourself
• American Psychological Association – Mental health apps are gaining traction

[Cover photo: Getty Images]