DEPARTMENT OF PSYCHIATRY

INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA

ARTICLE REVIEW

YEAR 5 BLOCK 5 (2022/2023)

TITLE:

THE EFFICACY OF MINDFULNESS-BASED MOBILE

APPLICATIONS ON MENTAL HEALTH AND WELLBEING

NAME: NIK KAMILLA IMAN BINTI NIK ABDULLAH

MATRIC NUMBER: 1818604
SUPERVISOR: DR HALIMAH HANIZAM
DATE OF SUBMISSION: 28th JULY 2023
INTRODUCTION

Mental health problems have been well-documented to be one of the leading contributors of
the global burden of the disease. With the COVID-19 pandemic that happened in 2020, the
prevalence of mental health problems such as anxiety, stress and depression has skyrocketed.
(Lahtinen et al., 2023). In Malaysia, according to National Health Morbidity Survey 2022, the
prevalence of depression among Malaysia adolescents is 26.9%. However, instead of seeking
proper and professional help, most individuals would opt for unhealthy coping methods such
as alcohol or substance abuse. (Lahtinen et al., 2023). This poses a serious threat to the future
of the community. In hopes of preventing this threat from happening, many efforts have been
made to improve the level of mental health and well-being of the population. Eventhough there
are abundant of empirically supported treatments that exist for mental health problems, most
people in need of these support do not actually have the access to these treatments. Some of
the barriers of treatment access includes the high costs, availability of clinicians, long waiting
times, stigma toward professional treatments and also preferences for self-help. (O’Daffer et
al., 2022).

According to Schultchen et al. (2021), mindfulness is described as an approach to be aware and

attentive of the present moment in an open and accepting way without any judgement or
criticism. Mindfulness which roots in the Easten cultures, was first introduced to the western
psychological world by Jon Kabat-Zinn and developed his Mindfulness-Based Stress
Reduction (MBSR) program. (Gál et al., 2021; Patatanian, n.d.). Jon Kabat-Zinn defined
mindfulness as “paying attention on purpose, in the present moment and non-judgementally to
the unfolding of experience moment by moment.”(Mani et al., 2015). There are various
mindfulness techniques that are used in the clinical practice as well as in health promotion such
as MBSR program and mindfulness-based cognitive therapy (MBCT). Mindfulness has been
found to be effective in psychological, somatic and interpersonal aspects as well as have been
found to reduce psychological distress and optimize psychological functioning in young
people.(Mani et al., 2015).

Today, using technology to deliver behavioural and lifestyle interventions, such as

mindfulness-based interventions, has become more and more common. This is especially
helpful and fitting for individuals who are unable to attend in-person sessions. (Avalos et al.,
2020). Thus, this comprehensive review aims to explore the efficacy of these mindfulness-
based mobile applications on multiple aspects of mental health and wellbeing including stress
reduction, anxiety and depression and sleep improvement.

LITERATURE REVIEW

The usage of mobile applications to deliver mindfulness meditation or therapy has increased.
People can easily and continuously access quick mindfulness exercises using these applications
for no cost or for a small fee. Mindfulness applications like Headspace, Calm, and Smiling
Mind provide daily guided meditations that can be customised to treat ailments like stress,
anxiety, or depression. These meditations typically run 10 to 20 minutes. Even though there are
thousands of apps for mental health, research has shown that Headspace and Calm consistently
score at the top in terms of downloads and user activity. In 2019, these apps had between 5 and
9 million active monthly users. (O’Daffer et al., 2022).

In a recent survey of 12,151 users of the Calm app, 41 percent of respondents said they had
been diagnosed with a mental health condition, such as depression, anxiety, or post-traumatic
stress disorder, and 76 percent said they had trouble sleeping. (2002). (Huberty et al. These
days, numerous randomised controlled trials (RCTs) show how well these apps work to lessen
anxiety, tension, and depression. Lahtinen and colleagues 2023. Using the Calm app, Huberty
et al. (2021) conducted a randomised controlled experiment with the goal of observing changes
in participants' levels of anxiety and depression. According to the study, those who used Calm
saw greater improvements in their levels of sadness and anxiety, with participants' scores on
the Hospital Anxiety and Depression Scale decreasing by an average of 1.3 and 1.8 points,
respectively (HADS).

A mindfulness-based app that uses mindfulness-based stress reduction (MBSR) approaches

was used in a random controlled experiment by Lyzwinski et al. (2019), and the results showed
that the intervention group utilising the mindfulness app experienced lower stress levels than
the control group. An app that promotes mindfulness was also found to have a small-to-
moderate impact on perceived stress, according to a meta-analysis. (Gál and others, 2021).
Another randomised controlled experiment was carried out by Bartlett et al. (2022) to
investigate the impact of mindfulness applications on lowering employee stress at work, both
with and without accompanying classes. This study discovered that the intervention group with
support classes reported a substantial rise in mindfulness and psychological distress when
compared to the control group. The group using merely the app, however, exhibited no
appreciable change in perceived stress.

A study was done by Huberty et al. (2021) to determine how mindfulness applications affected
the quality of people's sleep. They discovered that most participants said using a mindfulness
app made it easier for them to get to sleep, stay asleep, and have a peaceful night's sleep. The
frequency of using the app at night was positively correlated with the perceived improvement
in sleep quality. Participants using Calm reported considerable increases in their perception of
their sleep quality, according to a randomised controlled experiment examining the impact of
a mobile app for mindfulness meditation on adult sleep outcomes. These results imply that
mindfulness meditation applications could serve as a less expensive and intense supplement to
the gold standard treatment for those with sleep issues (J. L. Huberty et al., 2021).

DISCUSSION

According to the findings of the available research on the effectiveness of mindfulness-based

mobile applications, it has been demonstrated that these applications are useful in alleviating
the users' feelings of anxiety and depression. According to the reviews, these applications for
mindfulness have the potential to be a solution that could enhance the mental health of
individuals who suffer from depression and anxiety. However, the effects were only found on
those with less severe symptoms and the efficiency of these apps in reducing the symptoms
may only be demonstrated after they have been utilised for an extended length of time.
Therefore, in order for users to experience any real improvement, they need to maintain a
regular and frequent engagement with the apps. Therefore, this may be an indication that these
interventions are well-placed for delivering low intensity treatment or as a preventative
measure for mild to moderate depression among the millions of people who are affected by
subclinical symptoms.

Based on multiple literature, mindfulness-based applications have been found to reduce the
perceived stress level in users. However, these findings may also be influenced by the
demographics of the users. Younger adults, who are generally more accustomed to using smart
devices and technology, may find mindfulness-based applications more accessible and easier
to integrate into their daily routines. On the other hand, older adults may have different comfort
levels with technology, and the use of such applications might not come as naturally to them.
Additionally, they may have established stress reduction methods that they are more
comfortable with. For some older adults, these technologies may even introduce additional
stress or frustration if they are not familiar with the devices or the user interface of the
applications. Thus, it is important for developers to take into account the diverse needs of their
users.

Multiple findings have revealed the effectiveness of mindufness-based mobile applications in

improving sleep quality. According to a review by Garland and colleagues (2016), mindfulness-
based interventions may be especially helpful for cognitive deactivation and de-arousal by
enabling the person to disengage from daily struggles and concerns and ultimately encouraging
a shifting of one's relationship to sleep-related thoughts. This review was cited by J. L. Huberty
et al (2021). People can benefit from mindfulness techniques that encourage them to
concentrate on the present moment rather than dwelling on the past or the future. People who
practise mindfulness are also encouraged to accept these thoughts as they are without passing
judgement on them. With the presence of mindfulness based apps, these practices can be easily
accessible and affordable for the users to use in order to improve their sleep quality.
CONCLUSION

In conclusion, there has been an increase in incidences of depression, stress, and anxiety around
the world due to the worldwide weight of mental health concerns. Malaysia has experienced a
high frequency of mental health disorders among adolescents, similar to many other countries,
and many people have resorted to harmful coping techniques like alcohol or drug misuse.

High cost, a shortage of physicians, lengthy wait periods, the stigma attached to professional
therapies, and a preference for self-help are all obstacles to enhancing mental health and
wellness. Technology, especially mobile applications, has drawn the attention of researchers
and practitioners as a means of addressing these problems and expanding the reach of
mindfulness-based therapy.

Thanks to the rise of mindfulness-based mobile applications, people can now more quickly
access guided meditations and therapy sessions for stress, anxiety, and depression. Combining
technology with evidence-based practises like mindfulness is a potential strategy for tackling
the mental health challenges that affect communities all over the world. A future that is healthier
and more resilient will result from this. As technology and research develop, these apps could
play a bigger and bigger role in the promotion and care of mental health.
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