JMIR Publications

ABSTRACT

Background:

Currently, the screening of perinatal mental health symptoms is confined to maternity and primary care settings. Critically, the ever-increasing pressure on healthcare systems has resulted in under-recognition of perinatal mental disorders. Digital mental health tools, such as applications (apps) could provide an option for accessible perinatal mental health screening and assessments. However, there is a lack of information regarding the availability and effectiveness of perinatal app options.

Objective:

To evaluate the current state of diagnostic and screening apps for perinatal mental health available on the Google Play store (Android) and Apple App store (iOS), and to review their features following the App Evaluation Model framework.

Methods:

A systematic review approach was used to identify perinatal mental health assessment apps on the Apple App store and Google Play store. 14 apps met inclusion criteria, were downloaded, and reviewed in a standardized manner using the App Evaluation Model framework. The framework comprised 107 questions allowing for a comprehensive assessment of app origin, functionality, engagement features, security, and clinical use.

Results:

The majority of apps were developed by for-profit companies (n=10), followed by private individuals (n=2), and trusted healthcare companies (n=2). Three apps were only available on Android devices, four were available only on iOS devices, and seven on both platforms. Approximately a third of apps (n=5) had been updated within the last 180 days. Most apps did not have enough reviews to display average ratings. Twelve apps offered the Edinburgh Postnatal Depression Scale (EPDS) in its original version or in rephrased versions. Additionally, one app included screening scales for anxiety, insomnia, and post-traumatic stress disorder. Engagement, input, and output features included reminder notifications, connection to therapists, and free writing features. Six apps offered psychoeducational information or references. Privacy policies were available for 11 of the 14 apps, with a median Flesch-Kincaid reading grade level of 12.3 One app claimed to be compliant with Health Insurance Portability and Accountability Act standards, two apps claimed to be General Data Protection Regulation compliant. Of the apps that could be accessed in full (n=10), all appeared to fulfil the claims stated in their description. Only one app referenced a relevant peer-reviewed study. All the apps provided a warning for use highlighting that the mental health assessment result should not be interpreted as a diagnosis nor as a substitute for medical care, hence all the apps were regarded as reference apps and not self-help tools. Only three apps allowed users to export or email their mental health test results.

Conclusions:

These results support the view that there is space for designing and improving perinatal mental health applications. To this end, we recommend three areas of focus for app developers and clinicians looking to design apps for perinatal mental health assessment.