E-mental health applications for depression: an evidence-based ethical analysis
Abstract
E-mental health applications (apps) are an increasingly important factor for the treatment of depression. To assess the risks and benefits for patients, an in-depth ethical analysis is necessary. The objective of this paper is to determine the ethical implications of app-based treatment for depression. An evidence-based ethical analysis was conducted. The material was meta-reviews and randomized control studies (RCTs) on app-based treatment. Based on the empirical data, an ethical analysis was conducted using the 3-ACES-approach by Thornicroft and Tansella. Apps may empower autonomy, offer an uninterrupted series of contacts over a period of time, show evidence-based benefits for patients with subclinical and mild-to-moderate-symptoms, are easily accessible, may be used for coordinating information and services within an episode of care, and are on the whole cost-effective. Their risks are that they are not suitable for the whole range of severity of mental illnesses and patient characteristics, show severe deficits in the data privacy policy, and a big variability in quality standards. The use of apps in depression treatment can be beneficial for patients as long as (1) the usefulness of an app-based treatment is assessed for each individual patient, (2) apps are chosen according to symptom severity as well as characteristics like the patient's level of self-reliance, their e-literacy, and their openness vis-à-vis apps, (3) manufacturers improve their privacy policies and the quality of apps.
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Others report concerns from the point of view of security, privacy, and ethical implications of mental health apps.
“others report concerns from the point of view of security, privacy, and ethical implications [14,15].”
From A conversational artificial intelligence agent for a mental health care app: Evaluation study of its participatory design (2021) · cites this paper as [15]
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- Authors
- Rubeis, G.
- Affiliations
- Heidelberg University (DE)
- Corresponding author
- Rubeis, Giovanni
- ORCID
- Rubeis, Giovanni
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 2020-01-01
- Volume
- 271
- Issue
- 3
- Pages
- 549-555
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- OpenAlex
- W2998179725
- Cited by
- 17
- References
- 32
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 1
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- depression treatment, digital mental health, ethical implications, data privacy, symptom severity, patient autonomy, e-literacy, cost-effectiveness
- MeSH terms
- Internet-Based Intervention, Depressive Disorder, Humans, Mental Health Services, Psychotherapy, Review Literature as Topic, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Telemedicine, Ethical Analysis, Evidence-Based Practice, Mobile Applications
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