A little bird helps Sarah Mann deal with her anxiety and obsessive-compulsive disorder, but it isn’t a talkative parrot or a mockingbird. It’s a virtual avatar on Finch, a self-care app Mann has used at least once a day since August 2024.
The 18-year-old said Finch allows her to take control of her mental health. In the app, Mann can decide what tasks she wants to complete and reminders to receive.
“Having control over that has been very helpful in being able to control that sort of aspect of my mental health, and being able to be reminded to take a deep breath every once in a while,” Mann said.
Mann’s therapist recommended the app, and Mann said it reminds her of topics she and her therapist have discussed.
A University of Maryland freshman this past academic year, Mann said sending the “finch” on adventures makes the app interactive and entertaining, which encourages her to open the app’s notifications. Part of the app’s appeal is it feels like a game, she said.
Welcome to the modern world of mental health care, where help can arrive on your phone. Young people — and in fact, people of all ages — now have access to a variety of apps that can help them get through the day and through tough times.
Yet not all mental health apps are proven to be effective, said Adam Horwitz, a licensed clinical psychologist and assistant professor at the University of Michigan Medical School.
“A lot of them are out there without necessarily having undergone formal scrutiny to determine their effectiveness,” Horwitz said.
A variety of apps
The Finch app is just one of many apps that target mental health conditions. Some, like Finch, promote self-care and goal-setting while providing daily affirmations. Others teach users about coping mechanisms or allow users to record their emotions.
Prosper, a free mental health app, was developed to find a new way to help people with self-care, develop coping strategies and become more resilient, said Eric Sullivan, CEO of Uneo Health, which launched the app in 2023.
The app includes guided journals, daily check-ins, habit reminders, meditations and mindfulness videos.
Sullivan said the app is most often used to help with sleep, sadness, anxiety or stress.
For example, if a user is stressed, the guided journals can help identify why, while other features, such as breathing exercises, can help the user calm down.
Uneo Health and its partner agencies, including National Alliance on Mental Illness Maryland, received $1.4 million in state grants to share the app in Calvert, Frederick and Prince George’s counties.
Another app that works with schools is the Alongside platform, which also has a website.
Alongside was created by educators, therapists and psychologists in collaboration with about 100 teenagers to address youth mental health issues, said Elsa Friis, Alongside’s head of product and clinical.
According to Friis, the platform does that through various features, including mood trackers, videos that provide students with information on topics such as adjusting to college and Kiwi, a chatbot that uses artificial intelligence to simulate human conversation. Users can chat with Kiwi about their mental health and get recommended content based on the conversation.
The chatbot helps individualize care, Friis said.
“Whether that’s solving a conflict through compromise or acing a test or any of those daily challenges, the AI lets us make it really personal to you,” Friis said.
Are they effective?
But do apps such as Alongside really work? Some studies have shown mental health apps are moderately effective in addressing some mental health conditions.
A review published in the Journal of Counseling & Development in 2024 found when users of mental health apps are compared to those who received no treatment, the apps moderately reduced depression. In addition, the review — which examined 46 studies — found apps used for more than eight weeks were most effective.
In addition, Horwitz and other University of Michigan Medical School researchers published a study in 2024 that examined three different digital mental health interventions:
- The mindfulness app Headspace.
- The platform SilverCloud, which incorporates cognitive behavior therapy to help users identify and address negative thought patterns.
- The customized version of MyDataHelps, which informed participants of their sleep, activity and mood, and provided ways in which participants could improve them.
The study found all three moderately reduced anxiety, depression and suicide risk, without much difference among them.
Sometimes, however, the effectiveness of an app can be up to individual preferences, Horwitz said.
And not all apps work for everyone, said Catherine Gray, deputy director and clinical director at the Anne Arundel County Mental Health Agency.
“It’s not a one size fits all,” Gray said. “It’s really got to fit you.”
For Lena LaJoy, a 19-year-old Finch user, the app’s daily affirmations help her self-esteem. Like Mann, sending her virtual bird on an adventure is a motivator to complete tasks.
“It’s a good way to get you excited about doing your tasks instead of being worried about it or feeling overwhelmed,” said LaJoy, a freshman at the University of Maryland this past academic year.
LaJoy said she thinks the app is also a good way for people to learn more about their own mental health issues and get professional help if needed.
Aroosa Bhatti, a 24-year-old Howard County native, uses I am, a daily affirmation app that provides users with positive statements to dissuade negative thoughts and increase self-esteem.
Before she used the app, Bhatti said she often had negative thoughts. After using the app, her self-confidence increased, said Bhatti, who now lives in Calgary, Alberta, Canada.
“I was just able to look at the affirmation and it would help me with the rest of my day,” Bhatti said.
Jillian Alston, a Howard Community College student in her 20s, had been using the Calm app on and off for several years after her therapist recommended it, often using it during her work breaks, or before and after starting her shifts at the Burlington department store.
The app has features like meditation and stories users can use to help fall asleep.
Alston said the app helped her with her attention-deficit/hyperactivity disorder and to develop coping strategies for her anxiety and depression.
Jan Guszynski, the Prosper project lead for NAMI Maryland, also said these apps can help young people gain an understanding of their mental health and seek help.
“It is a good first step, and it’s a no-pressure step and it could lead to them, you know, telling adults in their life how they’ve been feeling,” Guszynski said.
Privacy concerns
However, these online tools can raise privacy concerns.
The apps aren’t always subject to the Health Insurance Portability and Accountability Act, according to the American Civil Liberties Union, and are only covered if conventional health care providers use or produce them. The act, known as HIPAA, regulates the disclosure of patient health information.
Some apps’ privacy policies don’t explicitly say they won’t use user information for advertising, said Erika Solis, an incoming assistant professor of communication and public speaking at Alfred State College in Western New York.
Solis also said an app’s use of AI chatbots could endanger a user’s privacy.
“Obviously, when you’re using AI on an app like this, or rather on applications like this, you’re hoping that it will tailor to you, but it’s still storing that data somewhere,” Solis said.
Alongside uses an AI chatbot, but Friis said the app is fully compliant with two federal privacy acts — one which requires parental consent to collect and share information for children under 13, and another that governs the sharing of “personally identifiable” information in student records.
The platform only shares information when a student is in immediate risk of harm, Friis said. Students can also elect to share information with their counselors.
Frederick County Public Schools no longer allows the Prosper app to be used on school Wi-Fi. That’s in part because of concerns over the collection of student information and students being able to access the app without parental consent, said Ann Workmeister, the system’s supervisor of mental health services
Sullivan said information provided to the Prosper app is kept in fully encrypted cloud storage. The app also collects minimal information and does not collect names, he said.
In addition, many mental health apps have not yet proven to be effective, Horwitz said. In part, that’s because many apps on the market may not have undergone scientific study.
“It’s a somewhat wild, wild west sort of thing with respect to how it gets put out there,” Horwitz said.
Apps also don’t hold people accountable in the same way therapy does, he said. A lot of people don’t use mental health apps for a long time, Horwitz added.
The apps can send users notifications, but ultimately users have to hold themselves accountable, unlike a therapy session where there’s an expectation the patient will show up, he said.
“At the end of the day, they are self-guided, and so if someone doesn’t have that motivation on their own to follow through, that can be a challenge,” Horwitz said.
For Mann, a key limitation of the Finch app is the questions the app asks about her emotions can be basic, while during her therapy sessions she can explore multiple aspects of her emotions.
The app is not a substitute for therapy but is useful as a supplement to that treatment, Mann said.
Emily Pasco, a mental health coordinator for Prince George’s County Public Schools, which has worked with Prosper since 2024, said when a student is experiencing more serious issues such as depression, the Prosper app should not be a substitute for therapy and other care.
The school system also recently started using the Alongside platform in a couple of schools.
Then there is the issue of cellphone overuse. Supreet Mann, the director of research at Common Sense Media — a nonprofit which helps educate kids, families and educators about technology and media, according to the organization’s website — said while cellphone overuse is a problem, it’s difficult to say whether mental health apps are contributing to that.
Accessibility
Still, some say there’s a place for mental health apps at a time when the need for mental health care outstrips its availability and accessibility.
Horwitz said mental health apps could make care more accessible for those without access to therapy or who are waiting.
Apps could also reduce waiting lines for therapy by helping those with more moderate issues, allowing those with more severe conditions to access necessary services earlier, Horwitz said.
“People might be able to move up more quickly, who really do need that … face-to-face care,” Horwitz said.
Meanwhile, LaJoy, the UMD freshman, said the Finch app can make taking care of one’s mental health easier, and make users feel more comfortable about expressing their feelings.
“I think if someone’s like, wanting to get help but worried about talking to someone, I think it’s a good way to do that,” LaJoy said.