mHealth for mental health: Integrating smartphone technology in behavioral healthcare.
Abstract
The rapid growth in the use of smartphones has opened a new world of opportunities for use in behavioral health care. Mobile phone software applications (apps) are available for a variety of useful tasks to include symptom assessment, psychoeducation, resource location, and tracking of treatment progress. The latest two-way communication functionality of smartphones also brings new capabilities for telemental health. There is very little information available, however, regarding the integration of smartphone and other mobile technology into care. In this paper, we provide an overview of smartphone use in behavioral health care and discuss options for integrating mobile technology into clinical practice. We also discuss limitations, practical issues, and recommendations.
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Recent studies have shown that those who received Web-based CBTi had improved sleep outcomes.
“Recent studies have shown that those who received Web-based CBTi had improved sleep outcomes [22-26].”
From Tamper-Resistant Mobile Health Using Blockchain Technology. (2017) · cites this paper as [22]
Predictive analytics can identify mental health crises early, and for healthcare workers can identify those at high risk of mental health issues before they manifest, enabling proactive intervention.
“Luxton et al. demonstrated the efficacy of predictive analytics in identifying mental health crises early, which is crucial for timely intervention [49]. For healthcare workers, predictive analytics can identify those at high risk of mental health issues before they manifest, enabling proactive intervention.”
From Mental Health in Healthcare Workers Post-COVID-19: A Latin American Review and Insights into Personalized Management Strategies (2024) · cites this paper as [49]
Smartphone apps may present a versatile and personalized platform for the delivery of a dedicated MBI for populations experiencing a concussion.
“Smartphone, or mobile, apps may present a versatile and personalized platform for the delivery of a dedicated MBI for populations experiencing a concussion [28].”
Many of the recent advances in smartphones have enabled the use of automated sensors and in-built cameras.
“However, many of the recent advances in smartphones have enabled the use of automated sensors and in-built cameras. 50”
From Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: A systematic review (2016) · cites this paper as [50]
Research on smartphone interventions for patients with chronic pain is limited.
“Web-based programs delivered through smartphones are increasingly used to support the self-management of various health disorders; however, research on smartphone interventions for patients with chronic pain is limited [17].”
There is the possibility of loss, theft, or malfunction of the mobile device, or cybercriminals specifically targeting health information, all of which could result in the loss of sensitive data.
“Furthermore, there is the possibility of loss, theft, or malfunction of the mobile device [5], or cybercriminals specifically targeting health information [207], all of which could result in the loss of sensitive data.”
From Smartphone Apps for the Treatment of Mental Disorders: Systematic Review (2020) · cites this paper as [5]
Among the advantages of using smartphones rather than traditional personal computers are their small size and mobility, making self-management support available to the user in most situations.
“Among the advantages of using smartphones rather than the traditional personal computer s are their small size and mobility, making self-management support available to the user in most situations [17].”
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“…to make behavioral health care more efficient and interactive for patients, but healthcare professionals should also assess the risks involved in using this technology and they should use the clinical judgment to consider when and for which of their patients need technology-based services [80, 81].”
BackgroundKuhn, E., Weiss, B. J., Taylor, K. L., Hoffman, J. E., Ramsey, K. M., Manber, R., Gehrman, P., Crowley, J. J., Ruzek, J. I., & Trockel, M. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.5700 · Cited by 135 · see citing works
Ye, X., Bapuji, S. B., Winters, S. E., Struthers, A., Raynard, M., Metge, C. J., Kreindler, S. A., Charette, C., Lemaire, J. A., Synyshyn, M., et al. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-313 · Cited by 134 · see citing works
“Mobile devices offer greater mobility and provide new opportunities to enhance the delivery of mental health and other medical services [36,37].”
BackgroundMobile Phones in Research and Treatment: Ethical Guidelines and Future Directions
Carter, A., Liddle, J., Hall, W., & Chenery, H. J. (2015) · JMIR mhealth and uhealth · doi:10.2196/mhealth.4538 · Cited by 133 · see citing works
“Mobile phones can then send this information to research or clinical teams, which enables timely responses that were not possible using older technologies [4].”
Innovative strategies for closing the mental health treatment gap globally
Rebello, T. J., Marques, A. D. F. H., Gureje, O., & Pike, K. M. (2014) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000068 · Cited by 130 · see citing works
mHealth For Aging China: Opportunities and Challenges
Sun, J., Guo, Y., Wang, X., & Zeng, Q. (2016) · Aging and Disease · doi:10.14336/ad.2015.1011 · Cited by 129 · see citing works
“smartphone use for early screening of cognitive impairment is convenient and efficient for the completion of assessments; it cane specially facilitate the early screening and effective assessment of elderly patients [46].”
BackgroundProudfoot, J. (2013) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867412471441 · Cited by 126 · see citing works
“…psycho-education, psychological therapy (guided and unguided), psychotherapeutic skills training and support – and for a range of mental disorders including depression, bipolar disorder, anxiety, addictions, psychosis, eating disorders as well as comorbid conditions (Luxton et al., 2011).”
BackgroundChatbots to Support Young Adults’ Mental Health: An Exploratory Study of Acceptability
Koulouri, T., Macredie, R. D., & Olakitan, D. (2022) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3485874 · Cited by 127 · see citing works
Automated ergonomic risk monitoring using body-mounted sensors and machine learning
Nath, N. D., Chaspari, T., & Behzadan, A. H. (2018) · Advanced Engineering Informatics · doi:10.1016/j.aei.2018.08.020 · Cited by 126 · see citing works
“Also, smartphone technology can be integrated with behavioral health care [6].”
BackgroundBrown, E. L., Ruggiano, N., Li, J., Clarke, P., Kay, E. S., & Hristidis, V. (2017) · Journal of Applied Gerontology · doi:10.1177/0733464817723088 · Cited by 123 · see citing works
Mobile health (mHealth) for mental health in Asia: Objectives, strategies, and limitations
Brian, R. M., & Ben-Zeev, D. (2014) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2014.04.006 · Cited by 121 · see citing works
Dagöö, J., Asplund, R. P., Bsenko, H. A., Hjerling, S., Holmberg, A., Westh, S., Öberg, L., Ljótsson, B., Carlbring, P., Furmark, T., et al. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.02.003 · Cited by 121 · see citing works
“However, there are few evidence-based behavioral and psychological smartphone applications and there is a need for controlled studies (Luxton et al., 2011).”
BackgroundApps and eating disorders: A systematic clinical appraisal
Fairburn, C. G., & Rothwell, E. R. (2015) · International Journal of Eating Disorders · doi:10.1002/eat.22398 · Cited by 121 · see citing works
“”(5) Many difficulties are addressed including anxiety disorders, depression, and excessive alcohol use, and the apps have a variety of functions including supplying information, self-assessment, self-monitoring, and the provision of advice or treatment.(6) The present study had three aims.”
BackgroundCarissoli, C., Villani, D., & Riva, G. (2015) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2014.0062 · Cited by 118 · see citing works
“49 Interventions using real time mobile technology have previously demonstrated efficacy to improve health outcomes in several domains, including anxiety and stress management.”
Reger, G. M., Hoffman, J. E., Riggs, D. S., ROTHBAUM, B. O., Ruzek, J. I., Holloway, K. M., & Kuhn, E. R. (2013) · Psychological Services · doi:10.1037/a0032774 · Cited by 117 · see citing works
Self-citationYouth Mental Health Interventions via Mobile Phones: A Scoping Review
Seko, Y., Kidd, S. A., Wiljer, D., & McKenzie, K. J. (2014) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2014.0078 · Cited by 117 · see citing works
“37 Thus, it is possible that these tools contain inaccurate information or provide interventions that do not adhere to the evidence-based literature and, as a result, inadvertently introduce patient safety risks.”
Yousaf, K., Mehmood, Z., Saba, T., Rehman, A. U., Munshi, A. M., Alharbey, R., & Rashid, M. (2019) · BioMed Research International · doi:10.1155/2019/7151475 · Cited by 116 · see citing works
Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System
East, M. L., & Havard, B. (2015) · JMIR Mental Health · doi:10.2196/mental.3954 · Cited by 115 · see citing works
“Luxton et al [20] provided an overview of mobile phone use in behavioral health care.”
InfluentialLu, C., Hu, Y., Xie, J., Fu, Q. J., Leigh, I., Governor, S., & Wang, G. (2018) · JMIR mhealth and uhealth · doi:10.2196/mhealth.9145 · Cited by 114 · see citing works
Determinants of mHealth success: An empirical investigation of the user perspective
Birkmeyer, S., Wirtz, B. W., & Langer, P. F. (2021) · International Journal of Information Management · doi:10.1016/j.ijinfomgt.2021.102351 · Cited by 115 · see citing works
“[ … ] several empirical studies have demonstrated the benefits of social networking sites for mental health and well-being [ … ] and smartphones increase opportunities for social networking by making social media sites more accessible ” (Luxton et al., 2011).”
BackgroundToward a Better Understanding of the Intention to Use mHealth Apps: Exploratory Study
(2021) · doi:10.2196/27021 · Cited by 108 · see citing works
“As has often been addressed in previous mHealth studies [114,115], health apps on smartphones can serve as very realistic health care alternatives, helping people save on medical expenses and being more effective in managing their personal health.”
BackgroundRobillard, J. M., Feng, T. L., Sporn, A. B., Lai, J.-A., Lo, C., Ta, M., & Nadler, R. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100243 · Cited by 111 · see citing works
A pilot digital intervention targeting loneliness in young people with psychosis
Lim, M. H., Gleeson, J., Rodebaugh, T. L., Eres, R., Long, K. M., Casey, K., Abbott, J.-A., Thomas, N., & Penn, D. L. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-019-01681-2 · Cited by 108 · see citing works
The Determinants of M-Health Adoption in Developing Countries: An Empirical Investigation
Alaiad, A., Alsharo, M., & Alnsour, Y. (2019) · Applied Clinical Informatics · doi:10.1055/s-0039-1697906 · Cited by 115 · see citing works
Ludwig, K., Arthur, R., Sculthorpe, N. F., Fountain, H., & Buchan, D. S. (2018) · JMIR mhealth and uhealth · doi:10.2196/10799 · Cited by 106 · see citing works
“However, there is a lack of evidence regarding the effectiveness of mHealth interventions on behavior changes and health outcomes [19,22,23].”
Velazquez, E., & Hernandez, M. Y. (2019) · Policing An International Journal · doi:10.1108/pijpsm-09-2018-0147 · Cited by 105 · see citing works
Users of the main smartphone operating systems (iOS, Android) differ only little in personality
Götz, F. M., Stieger, S., & Reips, U.-D. (2017) · PLOS ONE · doi:10.1371/journal.pone.0176921 · Cited by 127 · see citing works
“…caveats (e.g., ethical and technical considerations with respect to data privacy and confidentiality, data transmission and storage solutions, security issues, app quality, and safety) prevail that need to be addressed for the sake of sound and adequate research practices [14,15, 17,25, 27, 32].”
BackgroundLoo Gee, B., Griffiths, K. M., & Gulliver, A. (2016) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv043 · Cited by 92 · see citing works
“However, many of the recent advances in smartphones have enabled the use of automated sensors and in-built cameras.(50) These features can be accessed through native operating system programming libraries, which can be used to develop smartphone applications (apps).”
BackgroundSander, L. B., Schorndanner, J., Terhorst, Y., Spanhel, K., Pryss, R., Baumeister, H., & Messner, E.-M. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1701788 · Cited by 102 · see citing works
“…2015; Luxton, McCann, Bush, Mishkind, & Reger, 2011), possible harms in case of device failure, especially for patients relying on functional apps (Luxton et al., 2011), and a low quality of evidence of effectiveness as well as the absence of quality standards for the development of apps…”
BackgroundSmartphone Technology and Apps: Rapidly Changing Health Promotion.
Kratzke, C., & Cox, C. C. (2012) · The international electronic journal of health education · Cited by 103 · see citing works
Danaher, B. G., Brendryen, H., Seeley, J. R., Tyler, M. S., & Woolley, T. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.01.002 · Cited by 102 · see citing works
“Similarly, the smartphone's microphone can be used to record conversations with coaches/counselors for subsequent review (Luxton et al., 2011).”
BackgroundGlenn, T., & Monteith, S. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0523-3 · Cited by 104 · see citing works
A security framework for mHealth apps on Android platform
Hussain, M., Al-Haiqi, A., Zaidan, A. A., Zaidan, B. B., Kiah, M. L. M., Iqbal, S., Iqbal, S., & Abdulnabi, M. S. H. (2018) · Computers & Security · doi:10.1016/j.cose.2018.02.003 · Cited by 103 · see citing works
Chan, K. L., Leung, W. C., Tiwari, A., Or, K. L., & Ip, P. (2019) · JMIR mHealth and uHealth · doi:10.2196/12794 · Cited by 102 · see citing works
“There has been evidence showing that therapist audio recordings and remote communication between patients and service providers offered in mobile apps are flexible, portable, and relatively low cost, making them an ideal choice for patients who are restricted by time and location constraints and cannot partake in trad…”
BackgroundResultmHealth for Smoking Cessation Programs: A Systematic Review
Ghorai, K., Akter, S., Khatun, F., & RAY, P. K. (2014) · Journal of Personalized Medicine · doi:10.3390/jpm4030412 · Cited by 102 · see citing works
Zolfaghari, M., Shirmohammadi, M., Shahhosseini, H., Mokhtaran, M., & Mohebbi, S. Z. (2021) · BMC Oral Health · doi:10.1186/s12903-020-01374-2 · Cited by 102 · see citing works
Hilty, D. M., Chan, S. R., Torous, J. B., Luo, J. S., & BOLAND, R. J. (2019) · JMIR mhealth and uhealth · doi:10.2196/12229 · Cited by 101 · see citing works
“Another uses the Brief Symptom Inventory for monitoring [52].”
Niendam, T. A., Tully, L. M., Iosif, A., Kumar, D., Nye, K. E., Denton, J. C., Zakskorn, L. N., Fedechko, T. L., & Pierce, K. M. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.10.017 · Cited by 101 · see citing works
Mikolasek, M., Witt, C. M., & Barth, J. (2018) · JMIR mHealth and uHealth · doi:10.2196/11271 · Cited by 83 · see citing works
“psychoeducation), engaging audio and/or visual material, potential customization of the app according to client’s preferences and needs, provision of regular feedback, reminders, and reduced perceived stigmatization due to potentially less therapist contact [24, 26].”
BackgroundNew Directions in the Cognitive-Behavioral Treatment of OCD: Theory, Research, and Practice
Abramowitz, J. S., Blakey, S. M., Reuman, L., & Buchholz, J. L. (2018) · Behavior Therapy · doi:10.1016/j.beth.2017.09.002 · Cited by 98 · see citing works
Legal, Regulatory, and Risk Management Issues in the Use of Technology to Deliver Mental Health Care
Kramer, G. M., Kinn, J. T., & Mishkind, M. C. (2014) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2014.04.008 · Cited by 97 · see citing works
Self-citationJavaid, M., Haleem, A., & Singh, R. P. (2024) · Informatics and Health · doi:10.1016/j.infoh.2024.05.001 · Cited by 121 · see citing works
Emerging Technologies for Next Generation Remote Health Care and Assisted Living
Ahmad, I., Asghar, Z., Kumar, T., Li, G., Manzoor, A., Mikhaylov, K., Shah, S. A., Höyhtyä, M., Reponen, J., Huusko, J., et al. (2022) · IEEE Access · doi:10.1109/access.2022.3177278 · Cited by 101 · see citing works
“Various studies, such as presented in [37], show that the role of smart phones is increasing and useful applications for patient training, sickness self-administration, and remote”
BackgroundMental Health Apps: Innovations, Risks and Ethical Considerations
Giota, K. G., & Kleftaras, G. (2014) · E-Health Telecommunication Systems and Networks · doi:10.4236/etsn.2014.33003 · Cited by 89 · see citing works
“Mental health professionals should carefully screen any apps that they are recommending and inform clients on whether their use could compromise their privacy [3] [4].”
BackgroundWright, K. B. (2016) · Frontiers in Communication · doi:10.3389/fcomm.2016.00010 · Cited by 96 · see citing works
“Both innovations have led to the burgeoning field of MHealth (Luxton et al., 2011; Boulos et al., 2014).”
BackgroundInfluentialA Pilot Digital Intervention Targeting Loneliness in Youth Mental Health
Lim, M. H., Rodebaugh, T. L., Eres, R., Long, K. M., Penn, D. L., & Gleeson, J. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00604 · Cited by 91 · see citing works
Hwang, W. J., & Jo, H. H. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16214270 · Cited by 86 · see citing works
“Consumers (patients) and healthcare providers can use apps without the limitations of time or space, and mental health apps could provide healthcare services for many problems, including depression, anxiety, and addiction, based on the WHO’s definition of mental health, which is “the status of being able to deal with…”
BackgroundEffectiveness of ICT-based intimate partner violence interventions: a systematic review
El Morr, C., & Layal, M. (2020) · BMC Public Health · doi:10.1186/s12889-020-09408-8 · Cited by 90 · see citing works
A systematic review of mHealth interventions for the support of eating disorders
Anastasiadou, D. T., Folkvord, F., & Lupiáñez‐Villanueva, F. (2018) · European Eating Disorders Review · doi:10.1002/erv.2609 · Cited by 87 · see citing works
Austin, J., Drossaert, C. H. C., Schroevers, M. J., Sanderman, R., Kirby, J. N., & Bohlmeijer, E. T. (2021) · Psychology & Health · doi:10.1080/08870446.2019.1699090 · Cited by 88 · see citing works
Hilty, D. M., Yellowlees, P., Parrish, M. B., & Chan, S. R. (2015) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2015.05.006 · Cited by 88 · see citing works
Computer-based and online therapy for depression and anxiety in children and adolescents
Stasiak, K., Fleming, T., Lucassen, M. F. G., Shepherd, M. J., Whittaker, R., & Merry, S. N. (2016) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2015.0029 · Cited by 87 · see citing works
“There has been some research into self-assessment and tracking tools (e.g., monitoring mood) but little in the way of interventions (Luxton et al. 2011).”
- Authors
- Luxton, D. D., McCann, R. A., Bush, N. E., Mishkind, M. C., & Reger, G. M.
- Venue
- Professional Psychology: Research and Practice
- Published
- 2011-12
- Volume
- 42
- Issue
- 6
- Pages
- 505-512
- ISSN
- 0735-7028 (ISSN-L)
- 1939-1323
- OpenAlex
- W2064721329
- Cited by
- 809
- References
- 38
- Citations by year
- 2026: 24 · 2025: 21 · 2024: 29 · 2023: 45 · 2022: 43 · 2021: 59 · 2020: 69 · 2019: 99 · 2018: 86 · 2017: 86 · 2016: 77 · 2015: 70 · 2014: 58 · 2013: 27 · 2012: 16
- FWCI
- 44.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Professional Psychology Research and Practice (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
- Keywords
- mobile health, mobile application, behavioral health services, telemental health, mobile technology integration, symptom assessment, psychoeducation, clinical practice integration
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