[HN Gopher] Are mental health apps better or worse at privacy in...
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       Are mental health apps better or worse at privacy in 2023?
        
       Author : light94
       Score  : 133 points
       Date   : 2023-05-02 11:56 UTC (11 hours ago)
        
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 (TXT) w3m dump (foundation.mozilla.org)
        
       | sundarurfriend wrote:
       | > Betterhelp has a $7.8 million dollar judgment issue against
       | them by the US regulatory agency the FTC for promising not to
       | share sensitive mental health information for advertising and
       | then turning around and doing just that.
       | 
       | I always wonder how things like this interact with sponsorship -
       | I hear a _lot_ of podcasts that have Betterhelp ads in them. I
       | wonder whether, if they knew about such issues, that would affect
       | their decision to take the sponsorship and promote them. Even if
       | not in a binary  "that's a non-starter" way, does it make people
       | less inclined to take them on, and more open to other sponsors?
       | Or do people not pay attention to their sponsors at all?
        
         | paulryanrogers wrote:
         | Podcasts I listen to often feel pretty disconnected from the
         | ads. Some do auto injection and may not know all (or any) of
         | the ads that any given user hears. And folks cannot be experts
         | in everything.
         | 
         | TWIT network does appear to try to vet their ads, even
         | criticizing former sponsors for lax security once things come
         | to light. Yet even they still promote Molecule and other
         | pseudo-sci junk.
         | 
         | On the whole I think the best are listener supported shows. But
         | I'm biased as I now work for a company that helps podcasters
         | sell ad-free and premium access.
        
         | picometer wrote:
         | The Skeptics' Guide to the Universe podcast dropped BetterHelp
         | as an ad sponsor immediately after hearing about this mess. So
         | there are some out there who care. It certainly increases my
         | (already high) trust in their podcast operations.
        
       | 6_6_6 wrote:
       | [flagged]
        
       | jacquesm wrote:
       | Beware of health care apps that masquerade as something else just
       | to sidestep regulation. If it provides health care services or
       | aims to perform some kind of medical function then by definition
       | it is a health care service and it ought to be regulated as such.
       | If it isn't that's usually for a good reason, for instance
       | because the purveyors of the service do not expect that they will
       | be able to pass compliance review.
        
         | jnovek wrote:
         | Compliance review? Like HIPAA? Or are you referring to FDA
         | approval?
         | 
         | As someone with a chronic medical condition, my experience is
         | that software approved by the FDA are often prohibitively
         | expensive (they are considered medical devices) and not covered
         | by insurance.
        
           | jacquesm wrote:
           | The key indeed is that they can be considered medical
           | devices, and medical devices are a regulated class of devices
           | (depending on where you live these can have all kinds of
           | compliance requirements imposed on them). Compliance is
           | expensive, difficult and tends to constrain what you can do
           | with your data. So companies that want to side-step
           | compliance will work hard to avoid being labeled a medical
           | device. Whether your insurance covers the costs or not is yet
           | another aspect, typically if your insurance company isn't
           | going to reimburse you for an app that is classed as a
           | medical device they _definitely_ aren 't going to reimburse
           | you for other kinds of apps that are not approved.
           | 
           | Note that not all software only applications in the medical
           | domain are immediately considered medical devices, the line
           | is a pretty fine one. If you plan on putting out an app that
           | has medical implications you should research this properly to
           | avoid running afoul of the regulators (which isn't a very
           | good way to start your relationship).
        
             | jnovek wrote:
             | > if your insurance company isn't going to reimburse you
             | for an app that is classed as a medical device they
             | definitely aren't going to reimburse you for other kinds of
             | apps that are not approved.
             | 
             | Insurance companies are loathe to cover even FDA approved
             | _physical_ devices. Insurance is enthusiastic to classify
             | such things -- even treatments that are decades old -- as
             | experimental. The only devices that are a shoe-in are
             | things with widespread adoption like CPAP or pacemakers. If
             | your condition is uncommon, you'll be paying out of pocket.
             | 
             | That wipes FDA approved apps off the map for most of us.
             | Meanwhile, the app store is full of apps the claim to
             | provide relief for various conditions for just $14.99/mo.
             | Some of them are even actually effective.
             | 
             | I'm definitely not arguing that this state of affairs is a
             | good thing, but it is pragmatic reality for those of us
             | with chronic conditions. Unless we have truly fantastic
             | insurance or loads of income (things that are often
             | mutually exclusive with chronic conditions), we are priced
             | out of the tools that are most trustworthy.
        
               | jacquesm wrote:
               | This is a failure of health care systems. The degree to
               | which healthcare has been made into a differentiating
               | factor between the haves and have nots is astounding (to
               | me, at least). You'd think the first thing a developed
               | country would do is to ensure that healthcare was
               | universal and completely free, instead it is used as a
               | source of income because health is 'priceless'. It
               | bothers me tremendously but I don't see what I could
               | realistically do about it.
        
         | photochemsyn wrote:
         | Very true. Most people wouldn't use an app they downloaded to
         | their device to help them manage health conditions related to
         | cancer, heart disease, or infectious disease. They'd almost
         | certainly want private confidential consultations with a real
         | doctor (although quite a few doctors have served as little more
         | than salespeople for the pharmaceutical opiate manufactures).
        
       | jermaustin1 wrote:
       | My wife is a psychotherapist, and I go to therapy, and so does
       | she (on top of paid supervision and support).
       | 
       | It is the sad state of insurance and mental health coverage in
       | the US that is driving users to these apps that have no/little
       | proven benefit. Then the high cost of education has made it
       | practically impossible to provide low/no cost mental health
       | services.
       | 
       | My wife's internship was at a place where she had 8+ sessions per
       | day, they had a dozen or so unpaid interns still in school
       | (usually second year of masters program) providing mental health
       | services for low-income medicaid patients. And that leads to very
       | quick burn out, and doesn't compensate fairly (or at all,
       | actually) while accruing massive amounts of student debt.
       | 
       | There are federal programs that if you make it 10 years in
       | community mental health paying your student loans at a lower
       | rate, your loans are discharged, but it takes a very special
       | person to survive 40+ hours per week of sessions, taking in and
       | holding other people's mental health, and then add another 10+
       | hours of notes/insurance/treatment plans.
        
         | ChrisMarshallNY wrote:
         | I have family that is quite severly mentally ill.
         | 
         | They are on SSI and Medic[are|aid] (not sure which).
         | 
         | The nice thing about their insurance, is that it covers 100% of
         | their mental health care needs.
         | 
         | I am not aware of any private insurance that even comes close.
         | The most I've seen, is a limited run of social worker
         | appointments. No inpatient, heavy co-pays, etc.
         | 
         | Mental health is _not_ a priority, in the US. We spend a lot
         | more effort and money, ensuring that mentally ill people have
         | access to weapons, than to care.
        
           | [deleted]
        
           | gs17 wrote:
           | > They are on SSI and Medic[are|aid] (not sure which).
           | 
           | The mnemonic I heard from Planet Money was "grey hair?
           | Medicare. Underpaid? Medicaid." Although Medicare will also
           | apply to people under 65 with some conditions.
        
             | akiselev wrote:
             | In school we were taught "we _care_ for the elderly, we
             | _aid_ the less fortunate " but that doesn't rhyme :-(
        
           | warent wrote:
           | [flagged]
        
         | funnym0nk3y wrote:
         | So it's the state of mental health coverage in Germany too.
         | It's bad. Although therapy is paid for by the mandatory health
         | insurance, there are multiple issues: Wait times of months up
         | to three quarters of a year for a place in hospital, similar
         | wait periods for outpatient care. A lot of therapists won't put
         | you on a waitlist anymore. Federal insurance won't issue more
         | permits for therapist so it's a constant fight for already
         | exhausted patients to find someone (not counting in of they get
         | along). On top, there is more and more pressure to keep mental
         | health costs down by limiting time for inpatient care, by
         | limiting (or severely hinder any extension) the amount of hours
         | and so on.
        
         | vorpalhex wrote:
         | 1. Apps seem to be a useful tool. They help a lot of people who
         | either won't use or are not helped by traditional therapy.
         | Think of them like workbooks - they're an alternative that may
         | be better for some.
         | 
         | 2. There is no country as far as I'm aware that can meet the
         | demand for mental health services, from the most socialized to
         | the most open market. None. Therapists are always full, most
         | people don't want to be therapists, and the demand for them is
         | super high.
         | 
         | I have no idea how to solve this. A lot of therapists also tend
         | to stop being therapists pretty early in their career or
         | radically reduce how many patients they see. Basically it just
         | sucks to be a therapist no matter how much we pay and we can't
         | make it better.
        
         | LocalH wrote:
         | If you look around in the world, you see all these little
         | pockets of bullshit, where those in power and control see the
         | system as a way to _screw over_ and _steal_ from the individual
         | who 's just trying to live their life.
         | 
         | It's the mentality that making as much money as possible is
         | _the sole reason we exist_. Paying interns nothing because
         | "they're in school, learning" is no different than saying you
         | don't want to pay college athletes because "they're supposed to
         | be in school". Nah, you just want free work from people who
         | you've led to believe that the way to grow in their life is to
         | give you that free work.
         | 
         | Pay your workers, whether they're students or not. Stop working
         | for free.
        
         | davely wrote:
         | After struggling for years, I finally found someone through
         | Kaiser (my insurance company for those outside of west coast
         | USA), and they were absolutely phenomenal.
         | 
         | By some sort of fortunate occurrence, I started talking to them
         | about 3 weeks before the COVID lockdowns. I don't know how I
         | would have survived if not for him.
         | 
         | Sadly, due to how Kaiser treats their mental health staff, they
         | decided to move on (and leave practicing therapy). Since he was
         | moving on, Kaiser booted me out of their services since I
         | wasn't a case that necessitated emergency treatment (they are
         | right, but I still needed to _talk to someone_).
         | 
         | It's led me down a rabbit hole of trying to find various
         | therapists. Most in this area are at capacity (naturally,
         | everyone needs a therapist right now) or won't accept the third
         | party service Kaiser partners through.
         | 
         | I ended up doing Betterhelp for a bit and that was such a mixed
         | experience. Therapists that are overbooked and just grinding
         | (one told me they have 70 clients a week! Uh, what?!) and the
         | support was just so sub-par.
         | 
         | Specifically due to privacy concerns (and I think it's only a
         | matter of time before these services have some sort of data
         | breach), I registered with a throw away email, truncated my
         | name, and generally just tried to provide very little
         | identifying info.
         | 
         | (I guess they have my credit card details. Oh, well)
        
       | photochemsyn wrote:
       | A good example of social dystopia would be a situation in a
       | country where economic stress is driving depression and anxiety
       | and suicidal ideation and the solution proferred is to install an
       | app on your phone that sends you 'positive messages' and directs
       | you to spend what little money you have on drugs that make you
       | feel better. A good analysis of this situation is here:
       | 
       | https://www.nytimes.com/2022/09/20/opinion/us-mental-health-...
       | 
       | > "That the status quo is once again benefiting the usual
       | suspects is all too obvious in the booming market of venture-
       | capital-backed mental health tech start-ups that promise to solve
       | the crisis through a gig economy model for psychiatric care -- a
       | model that has been criticized for selling psychiatric medication
       | irresponsibly, with little accountability..."
       | 
       | > "And yet when the plan addresses suicide, it focuses on crisis
       | intervention -- as if suicide were a kind of unfortunate natural
       | occurrence, like lightning strikes, rather than an expression of
       | the fact that growing numbers of people are becoming convinced
       | that the current state of affairs gives them no reason to hope
       | for a life they'd want to live..."
       | 
       | P.S. Another good read:
       | 
       | https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_...
       | 
       | Historical societal failures in the Soviet Union have many
       | interesting similarities to current societal failures in the
       | United States.
        
         | mtlmtlmtlmtl wrote:
         | Honestly if I was having one of my bad depressive episodes, and
         | someone told me to download a fucking app that's supposed to
         | help me by pandering to me, or I'm supposed to do therapy with
         | a fucking experimental language model. It might depress me so
         | much I'd finally have the motivation to end it.
         | 
         | Because yeah, that's dystopian as hell, not to mention
         | dehumanising.
        
           | adamwong246 wrote:
           | The idea we can treat mental health through yet an another
           | skinner box is a horrifying unfunny joke. Mental health
           | problems are literally caused by screen addiction and social
           | atomization. The solution is to put the phone down!
        
             | kayodelycaon wrote:
             | Other way around, screen addiction and social atomization
             | can and does cause mental health problems and make existing
             | mental health problems worse.
             | 
             | There are also a lot of mental health problems not caused
             | by these things. :)
        
           | vjk800 wrote:
           | To be fair, regular therapy is also slightly dehumanising and
           | dystopian. Not too long ago we had cultural constructions to
           | prevent the issues we are now solving with therapy. Do you
           | lack social context, close relationships and meaningful
           | interactions with other people? Wait until you go nuts and
           | then pay 100 euros a session to a stranger to help you deal
           | with it.
           | 
           | And I speak from experience after going to therapy for my
           | anxiety. I guess it sort of helped, but also I could very
           | easily imagine a world where the whole problem wouldn't have
           | existed in the first place - it's just not the world that we
           | live in.
        
             | fowtowmowcow wrote:
             | American here.
             | 
             | Visited a psych ward once (because suicidal idealization
             | was happening and I wanted/asked for help for the first
             | time in my life).
             | 
             | Well if my experience in one of those facilities is not an
             | uncommon one, then they are horrifyingly dehumanizing and
             | actually cause harm to other people (this is what I
             | observed).
             | 
             | A big problem in facilities is that the information they
             | receive will determine more of what they will do/prescribe
             | than what the patient is actually asking for.
             | 
             | I watched transgendered patients be purposely miss gendered
             | by staff. Countless other patients being otherwise ignored
             | or treated like anything they have to say doesn't matter
             | because of where they are or the diagnosis that they have.
             | 
             | For myself I was told I was schizophrenic and prescribe
             | meds with terrible side effects because my parents told
             | that to the admit facility. No treatment for depression and
             | anxiety was really given (which is what I was saying I
             | wanted), I was ignored by the therapist and social worker
             | assigned to me, and the contact that I wished to hear from
             | was conveniently removed from my file.
             | 
             | Therapists and support staff in the public sector outside
             | of a mental hospital are grossly underpaid, thus only the
             | inexperienced and inept (with a few people that care too
             | much for their own good) are the ones likely to be working
             | in Federally funded health centers.
             | 
             | Mental Healthcare is a abysmal joke in the United States.
             | Suicide is very easily a valid and top choice here.
        
             | kayodelycaon wrote:
             | It really depends why you're going to therapy. For myself,
             | I went into it with very specific goals. I wanted to learn
             | how to properly manage bipolar disorder. That's not
             | something any of my friends could have helped with. None of
             | them had heard of cognitive behavioral therapy before. (And
             | I had done a half-assed job of reinventing the concept.)
             | 
             | For me, therapy was very similar to private tutoring
             | sessions. I did almost all of the work. Took about a year
             | to nail down all of the corners. Haven't had to go back
             | since.
             | 
             | In an ideal world, therapists should be no different from
             | personal trainers. No one really questions having someone
             | help you learn how to exercise. Learning how to handle your
             | mental hardware should be the same way.
             | 
             | Granted, we're living in a Sci-Fi dystopia. We're have a
             | lot less problems if we didn't.
             | 
             | Therapy is a very poor replacement for having a good social
             | support system. But for some things, it's a resource your
             | usual support system is unlikely to have.
        
             | popotamonga wrote:
             | Why can't an app be a certified medical device? I'm
             | actually working on one and close to getting certification
             | as a medical device, which will then be rolled out by
             | hospitals etc.
             | 
             | Feedback from user testing has been great, patients loved
             | it generally.
        
               | hammyhavoc wrote:
               | Are you asking why it can't or why it _shouldn 't_?
               | Because it can be classified as such, as you're
               | experiencing first-hand.
        
             | Apocryphon wrote:
             | _Bowling Alone_ came out in 2000 and it's about trends
             | that's happened since the '50s. It's arguable that said
             | cultural constructions have been disappearing for a while.
        
               | 1attice wrote:
               | I always see "this is nothing new" used as a sort of
               | psychological defense against dismay.
               | 
               | Concerned about the latest reports on ocean warming?
               | Well, climate change has been happening for a while!
               | 
               | Concerned about the AI-fuelled destruction of art and
               | writing as middle-class careers? Don't worry, artists
               | have been poor for quite a while!
               | 
               | It's possible (and, indeed, _likely_ ) that:
               | 
               | - Things have gotten progressively worse
               | 
               | - There is a tipping point, after which the system will
               | undergo a phase change; i.e. the difference between
               | making rent and not making rent
               | 
               | - We are now much closer to that point than we were
               | 
               | Expected response is, "oh fsck, that makes the current
               | situation even worse, I should definitely care about it!"
               | Response I see instead is, "well that's old news."
               | 
               | (So, call this the Old News Defense.)
               | 
               | What is fascinating to me is the frequency with which
               | this defense is thrown up. I'm pretty sure that if we got
               | hit by an asteroid, someone would be commenting, "don't
               | worry, we've been getting hit with asteroids since
               | Chicxulub, stop being alarmist"
        
               | AlchemistCamp wrote:
               | > _I always see "this is nothing new" used as a sort of
               | psychological defense against dismay._
               | 
               | It's probably worth examining where this reflexive
               | response comes from. The person you're replying to didn't
               | defend anything. The comment was just that the trend
               | predates the past couple of decades.
        
               | 1attice wrote:
               | In context, I interpret GP as implying that things have
               | been bad for a while -- a sort of deflationary position
               | that is popular on HN when something Big is happening.
               | 
               | If that's not what's going on here, I apologize -- but
               | yes, it's a strong HN tendency. It's a sort of machismo
               | stance that derides alarm as alarmism, and it's quite
               | popular here. Cf. HN comments on pretty much any article
               | on AI from the past three months.
        
             | mtlmtlmtlmtl wrote:
             | I think it's unfair you're being downvoted for sharing your
             | experience.
             | 
             | Definitely agree that human therapists aren't perfect
             | either. I never had much success with therapy personally.
             | I've had to basically figure it all out myself. But I have
             | occasionally had some really good therapy sessions.
             | 
             | But ok, at least with a therapist, another human being
             | cares enough to want to help, and that can make a
             | difference.
             | 
             | Tell a heavily depressed person to use a chat bot, and
             | you're implicitly telling them they're so worthless that
             | they're not even worth another human having a conversation
             | with them. You might not mean that, but that is what the
             | depressed mind will read into it.
        
               | Gare wrote:
               | > But ok, at least with a therapist, another human being
               | cares enough to want to help, and that can make a
               | difference.
               | 
               | Usually there's money involved, no?
        
               | ambicapter wrote:
               | No one's forcing them to take that job so on some level,
               | yes, they do want to be there.
        
               | mtlmtlmtlmtl wrote:
               | Of course, but just because you're getting paid doesn't
               | mean you don't care. They might seem cold because they
               | have to practice a certain level of detachment. But most
               | therapists do care about their patients, that's why they
               | became therapists in the first place.
               | 
               | Also, therapists usually have long referral lists, so
               | they still have to decide that you're worth their time
               | and that they believe they can help you.
        
               | vjk800 wrote:
               | > But ok, at least with a therapist, another human being
               | cares enough to want to help, and that can make a
               | difference.
               | 
               | That's sort of my point. They don't actually care, they
               | help you because you pay them. I don't know if it's how I
               | grew up or what, but this is somehow off-putting to me. I
               | mean, I'm not against paying for services in general, but
               | the sort of human interaction that therapy provides seems
               | me like something that we should be able to get without
               | money.
        
               | waboremo wrote:
               | It would be great if therapy was provided under universal
               | healthcare!
               | 
               | But I would argue against the "don't actually care"
               | angle. They do, they would not have devoted years of
               | their life to a quite miserable role if they didn't care
               | about helping people. Their expertise matters, just like
               | any other role in life, and it's what you're paying for.
        
         | 7952 wrote:
         | This will start to happen in business. The company I work for
         | has high levels of stress. We now have lots of HR people
         | sending messages about mental health. Endless messages about
         | mindfulness, yoga, a monthly happy thoughts diary etc. At no
         | point does anyone acknowledge that maybe working conditions are
         | part of the problem. Or that the business has any culpability
         | for stress. It is just another growth vector for charlatans. A
         | corporate branded wellbeing app is the next logical step.
        
         | thenerdhead wrote:
         | This goes back even further. Humans have always desired a new
         | medication or technical invention to resolve the woe in their
         | souls.
        
         | jiggywiggy wrote:
         | Therapy is part of the problem. Often things that people think
         | should be solved by talking to therapist should actually be
         | solved by family, friends and mentors.
         | 
         | We try to profesionalize big parts of heathy communities and
         | families so we don't have to deal with its downsides.
        
           | waboremo wrote:
           | You realize a lot of the reason why people are in therapy is
           | because of family, friends, and mentors? Like it's not a lack
           | of initiative, or a lack of communicating; it's being shamed
           | by your own family, being manipulated by friends, etc. So
           | many of these problems stem because humans are fucking
           | complicated (and sometimes cruel) as hell.
           | 
           | So no, therapy is not part of the problem. Just because in
           | your hypothetical scenario therapy has now been spread across
           | multiple roles instead of a dedicated one, doesn't mean it
           | ceases to exist - you are now expecting your family, friends,
           | mentors, etc. to act as your therapist at will.
           | 
           | Unless you assume people are in therapy just because they get
           | annoyed at how their lover eats breakfast, or whatever
           | superficial aspect that could easily be solved with some
           | chat. I don't know many people paying the cost of therapy for
           | superficial problems like that but hey maybe in your
           | community they do!
        
             | YellOh wrote:
             | No need to strawman. I think jiggywiggy is just pointing at
             | the mental health issues demonstrably linked to atomization
             | and loss of community in the modern world. As a starting
             | point, consider the growing share of people who describe
             | themselves as having zero friends, and the links between
             | loneliness and mental health issues.
             | 
             | Some issues are caused by interpersonal conflict / abuse,
             | but we're delicate social creatures and a lack of family &
             | friends can also be extremely damaging. I doubt people are
             | going to therapy because of how their lover eats breakfast
             | (except maybe extreme misophonia), but there are plenty of
             | people justifiably upset about their complete lack of
             | emotionally intimate relationships with other people.
             | 
             | And, as mentioned above, many issues can be alleviated by
             | support from friends and family. At least ideally, if your
             | spouse hits you, you should be able to ask your family or
             | community for support. People lacking those outside
             | relationships only exacerbates mental health issues caused
             | in other relationships.
        
       | elesbao wrote:
       | The one mental health app I need is Gympass - Hitting the gym has
       | helping me cope with anxiety
        
       | prepend wrote:
       | I would only use a mental health app where the provider is hipaa
       | bound.
       | 
       | There's a rash of "non-health" mental health apps and that's just
       | scary.
       | 
       | But even under hipaa providers, I expect they are deidentifying
       | under safe harbor and reselling as much as possible. Imagine the
       | training possibilities on all transcripts "scrubbed of pii."
        
         | 6_6_6 wrote:
         | hipaa is a joke
        
         | wing-_-nuts wrote:
         | I wonder when things will progress to the point where you could
         | run a LLM that would do a _good enough_ impression of a
         | therapist on a 4090. I honestly think the only way I could
         | trust something like this is if it was running on my own
         | hardware, or a private cloud instance.
        
         | bearjaws wrote:
         | Nothing is safe sadly, HIPAA does almost nothing, in reality
         | very few companies actually get the full fat $1000 per patient
         | fine. Even the regulation itself is now hilariously outdated,
         | "encrypted at rest and transit" is absolutely the lowest bar
         | for security.
         | 
         | There are way too many fast and loose players in the mental
         | health space, they do not care to actually have security. They
         | do not have separate roles for security and engineering.
         | 
         | These startups only have to pretend to have security to appease
         | their VCs. In Series B they MAY get a small security audit, but
         | they already lie on their SOC2 or ISO27000... so whats some
         | more lies?
         | 
         | The idea of having a rigorous process that ensures security is
         | completely unacceptable if it adds any time to market.
         | 
         | This is why we see numerous hacks in the health tech space.
        
       | RcouF1uZ4gsC wrote:
       | I think a better question is if mental health apps actually help
       | mental health.
       | 
       | You are still giving them pretty private information. If they
       | actually provide a benefit, that might be worth it. But I am not
       | convinced they are actually helpful.
       | 
       | My guess is that exercise, especially outdoor exercise or getting
       | together with friends has far more mental health benefit than
       | these apps and also much less privacy downsides.
        
         | meerita wrote:
         | I was about to ask if anyone used one and noticed improvements.
         | To me these mental apps sound like a scam.
        
           | vorpalhex wrote:
           | Studies suggest they work very well for some users.
           | https://pubmed.ncbi.nlm.nih.gov/32480319/
        
         | viraptor wrote:
         | Which mental health apps? There's a massive difference between
         | Calm, Better Stop Suicide and PTSD-related apps. Also it's not
         | like people are making a choice between whether they meet
         | friends or install Calm.
        
           | williamtrask wrote:
           | > Also it's not like people are making a choice between
           | whether they meet friends or install Calm.
           | 
           | Neither meeting friends or using an app are binary events.
           | The more you spend time on one, the less you spend time doing
           | anything else -- in the limit including the other. There's
           | considerable evidence to suggest app and/or media usage
           | encroaching on in-person time. It seems plausible that people
           | who can band-aid their feelings in an app may be less
           | inclined to take the leap and talk about personal matters
           | with friends.
           | 
           | But these are complex things - there would need to be a study
           | to know for sure.
        
           | throwaway22032 wrote:
           | Yes, that is exactly the point.
           | 
           | People are not actively making a choice, they are passively
           | making the choice to sit on their phones.
        
         | mattwest wrote:
         | How would you feel about a lifestyle guidance app?
         | 
         | Perhaps something that uses CBT, gratitude, and postive
         | reinforcement to help people build good exercise and diet
         | habits?
         | 
         | Is there a way for a company to implement sufficient privacy
         | protocols that would appease the most privacy-concious users?
        
           | blep_ wrote:
           | > Is there a way for a company to implement sufficient
           | privacy protocols that would appease the most privacy-
           | concious users?
           | 
           | The trivial way is to just _not send data back to the
           | internet_. Nothing you listed here is impossible to do client
           | side.
        
       | slackfan wrote:
       | Are any of the mental health apps not just glorified pillmills?
        
         | harvey9 wrote:
         | There are lots of apps which do not connect you to a doctor and
         | therefore do not connect you to pills either. Is that what you
         | meant? The apps I have in mind are based mostly on CBT and/or
         | mindfulness.
        
           | Regnore wrote:
           | What is CBT in this context because the CBT that comes to my
           | mind - while fantastic if that's what you're into - would not
           | typically be useful as a mental health treatment
        
             | 50 wrote:
             | > while fantastic if that's what you're into - would not
             | typically be useful as a mental health treatment
             | 
             | hopefully you were thinking of cognitive behavioral therapy
             | because you would be correct:
             | 
             | > Whenever one hears the claim that CBT is the more
             | 'effective' treatment, we can confidently translate this to
             | refer to its role as the most cost-effective form of
             | psychological social control[1]
             | 
             | 1: https://melbournelacanian.wordpress.com/2014/02/04/the-
             | found...
        
             | sharatvir wrote:
             | It's most definitely Cognitive Behavioral Therapy https://e
             | n.m.wikipedia.org/wiki/Cognitive_behavioral_therapy
        
               | Regnore wrote:
               | Thank you. I was afraid to google CBT at work.
        
             | colineartheta wrote:
             | Cognitive Behavioral Therapy
        
       | [deleted]
        
       | cassiebender wrote:
       | In 2023, mental health apps have significantly improved their
       | privacy practices.Front end development has played a key role in
       | creating user-friendly interfaces, implementing stronger
       | authentication and encryption protocols, and allowing users to
       | customize their privacy preferences. These efforts have resulted
       | in apps that are better at protecting user privacy, building
       | trust with their users, and providing valuable mental health
       | support.
        
         | nexthash wrote:
         | Is this a joke? How could you possibly believe in this
         | delusion, when these apps have been shown over and over again
         | to be gaslighting vulnerable people into divulging sensitive
         | information about themselves to a VC-backed ad pipeline. Have
         | you seen BetterHelp's ads on YouTube? Pure manipulation of
         | people who are suffering.
        
       | lykahb wrote:
       | Here is some free mental health advice: put the phone away.
        
       | bowel wrote:
       | There's also 29k.org, a non-profit foundation and an open-source
       | mental health app, where privacy were taken very seriously.
       | https://29k.org/ https://github.com/29ki/29k
       | 
       | Disclaimer: I used to work here.
        
       | SamoyedFurFluff wrote:
       | I continue to be frustrated that politicians and lawmakers are
       | more focused on culture war stuff than they are focused on
       | updating sensible laws to the modern technologies of the time. I
       | hear more about random ousting of people and whatever said
       | something stupid on social media than I do about serious pushes
       | to protect vulnerable populations online...
        
         | davidthewatson wrote:
         | Having built remote healthcare five years prior to Covid under
         | HIPAA where you have an interdisciplinary team on the coach
         | side and a chronically ill and vulnerable patient on the iPad
         | side, who frequently have little to no mental model of what
         | these "tin screens and string tubes" are doing to help them,
         | the notion that "sensible laws" exist to govern any of this is
         | beyond me. The chasm of disconnects between legal, politics,
         | and tech has only gotten broader and deeper over the last 30
         | years while we realize that there was a reason that innovators
         | were talking about the need for interdisciplinary work in the
         | 50s before we deprecated the humanities. "Things that don't
         | scale" is a mild understatement from costs to benefits. It
         | makes, "another day at the office" look like the Khumbu Ice-
         | fall.
        
         | paulryanrogers wrote:
         | Talking about mental health is high risk, low reward for
         | politicians. Culture and class divisions are the opposite.
        
       | sundarurfriend wrote:
       | > Betterhelp has a $7.8 million dollar judgment issue against
       | them by the US regulatory agency the FTC for promising not to
       | share sensitive mental health information for advertising and
       | then turning around and doing just that.
        
         | nluken wrote:
         | Million, with an M? Might as well be a jaywalking ticket.
        
       | evilspammer wrote:
       | [dead]
        
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