Mental health apps may help those waiting for care, according to a study from the University of Michigan.

Depression, anxiety and suicide risk dropped when patients awaiting an initial psychiatric appointment used smartphone apps to get cognitive behavioural therapy (CBT), mindfulness or encouragement prompts.

The recent surge in people seeking mental health care has led to long wait times for first appointments with therapists and psychiatrists. Now, a study is offering hope that, while they wait to get care, patients could still get some relief by using evidence-based smartphone apps and wearable devices to track sleep and activity.

The study shows depression and anxiety symptoms, and suicidality, all decreased measurably when patients were assigned to mobile apps that incorporated mindfulness practices, CBT skills, or prompts that encouraged mood-enhancing activities.

The research, conducted at Michigan Medicine (www.michiganmedicine.org), the University of Michigan’s academic medical centre, was published in Jama Network Open (jamanetwork.com/journals/jamanetworkopen/fullarticle/2821341). It involved just over 2000 patients scheduled to get care in coming weeks from a mental health provider at outpatient U-M Health or U-M student clinics.

Adam Horwitz, U-M Medical School psychologist who is the paper’s lead author, called the results encouraging, with implications for individuals and clinics alike.

“Having this type of option, especially for people who are motivated enough to seek an appointment and wait for it, could be very valuable when providers have long wait lists,” said Horwitz. “These individuals want to be doing something about their mental health but don’t yet have access, so this suggests that providing them with some sort of digital option when their motivation is already high, and they are ready to do something, could begin to make a difference.”

Nearly all the patients completed standard mental health assessments both at the start of the study and after six weeks of using the app they had been randomly assigned to install on their smartphone. All participants also wore a study-provided Fitbit or their own Fitbit or smartwatch, to track sleep and physical activity.

The study randomly assigned most participants to one of two commercial apps – Silvercloud, which is based on CBT principles, and Headspace, which coaches users in mindfulness techniques. Both apps have been shown separately to help alleviate mental health symptoms, but have never been tested against one another.

Some study participants were randomly assigned to receive a customised version of the study app called MyDataHelps, either alone or together with one of the commercial apps. Those randomised to receive this app received positive encouraging prompts twice per day based on their activity tracker data – for example, applauding them for walking or getting a good amount of sleep, or suggesting a simple act to improve their mood.

No matter what group they were in, the participants’ scores on standard mental health scales changed for the better by the end of the study period. The largest improvement was among participants using Headspace.

Most study participants had their initial appointment with a U-M mental health provider before the end of that six-week period, but the drop in mental health scores was similar for those who hadn’t yet started professional treatment.

Horwitz said the study helped inform the development of a much larger study called Compass at U-M that just received $17.9m in funding from the National Institute of Mental Health (medicine.umich.edu/dept/psychiatry/news/archive/202407/%E2%80%98trial-error%E2%80%99-targeted-precision-179m-grant-accelerates-u-m-mental-health-research). The Compass study will involve not only smartphone apps, wearable activity trackers and standard mental health assessments, but also genetic tests and other types of data collection. It will involve thousands of U-M Health and U-M student clinic patients who are waiting for their first mental health-related appointment.

Horwitz said people seeking mobile-based mental health support have many apps to choose from, and that most of those apps haven’t gotten scrutiny through objective research. Headspace and Silvercloud have more objective evidence behind them than most of these apps, he said.

Because mental health conditions can wax and wane in their symptom severity, apps that support someone during an especially low mood or high anxiety time could be important for helping them endure the time until their first appointment.

Horwitz said the study participants’ clinical providers didn’t have access to their app data. But he said this might be a potential option for clinics moving forward if patients wanted to grant that access by allowing their app to share a summary with their clinic. Data from mental health apps could even potentially help providers or systems understand which patients need the most-intensive approaches to psychiatric care, and which might be able to do all right with less intensive care. That could also improve waiting lists for all patients.

“If we can use apps to give the patient a bit of momentum on understanding and managing their symptoms, even before they get to clinic, then perhaps that will help them get more out of therapy once they get to clinic and pass the baton from the app to a professional provider,” he said. “The apps don’t have the same effect as therapy, but doing something while waiting is still important.”