Generally speaking Mental Health apps don’t have much of an evidence base. For that reason, if you are a mental health practitioner, it’s important to take a close look yourself at any apps you plan to recommend.
I asked Casey, a patient of mine with significant relevant lived experience, to take a look at an app called “Calm Harm”, which was designed to help people overcome the urge to self-harm. Here’s what she had to say:
“The Calm Harm app is a potentially useful resource people can use in times of distress or crisis. It is easy to use and has a lot of suggestions for things you can do to reduce your distress without resorting to destructive coping mechanisms. There are four categories of activities: Comfort, Distract, Express and Release. Each category has different sorts of activities to help overcome urges to self-harm and bring your level of distress down. Each category can be useful in different situations, or intensity of emotions.
The timer is great as it gives you two options, 5 minutes and 15 minutes, however when distressed even 30 seconds seems like too much so what is great about the timer on Calm Harm is it breaks it up in 60 second intervals and asks you at the end of each 30 seconds whether or not the urge has passed, or if you require more time and suggestions. When I first used the app, the initial 60 seconds seemed like forever and the urge didn’t pass so I started the timer again and each time I did the time passed quicker and my urges decreased.
There are a couple of things to be aware of when using the app however. Some of the suggestions may not be useful for everyone, and could actually be triggering. For example using ice pressed against your skin, or snapping an elastic band on your wrist are two suggestions in the “release” category that are triggering for me, but may be helpful for someone else, so it would be good if the app had the option for deleting suggestions, or at least have a disclaimer that some of the activities may be triggering to some.
Another useful function is the option to add your own activities if there are other things you know have been helpful that may not already be in the app.
The app is password protected which is a good idea but I think the app should suggest that you set an easy to remember, and simple password because in times of great distress it is difficult to remember some things and if you keep getting the password wrong it could lead to increased distress and the likelihood that you will give up on using the app and go straight to self-harm, or whatever destructive coping mechanism you were trying to avoid.
I also think it would be a good idea to have the option to add contact details of support people so that they are on hand easily should your level of distress and urges not subside and you need help. The app could suggest you contact a support person and give you their contact details, or even emergency services.
I guess the bottom line is that this is potentially a useful tool but it may not be appropriate for everyone.