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Mindfulness in the Media: Where is the science behind mental health apps?

Title: Mindful mindfulness reporting: Media portrayals of scientific evidence for meditation mobile apps

Author(s) and Year: Stacey Leigh Walker and John Noel Viaña, 2023

Journal: Public Understanding of Science (closed access)

 

TL;DR: Promoting the importance of evidence-based journalism, Walker and Viaña highlight how mindfulness apps are being promoted in the media without scientific backing. They found that only 2% of apps used academic research to back up their claims, and less than a third included advice from a health expert. The authors highlight the risk of overly promoting such apps without mentioning their potential risks. The study is an interesting case study of how eHealth is promoted in the media.


Why I chose this paper: I am interested in the link between mindfulness and mental health. Often, I worry these apps attribute adverse mental health to a lack of self-care, shifting the perceived cause away from medical illness and instead blaming an individual's failure to find time to be mindful.


 

When remote work increased during the COVID-19 pandemic, so did reports of mental illness. With the World Health Organisation reporting a 25% increase in the prevalence of anxiety and depression worldwide, it is no surprise that the use of mental health apps has also increased. In April 2020, the first month of lockdown, the United States' leading mindfulness app, Calm, had 3.9 million installs, with more than one download a second. Headspace, the United Kingdom’s leading app, was a close second with over 1.5 million downloads in April 2020.


It is hard to escape these apps as their promotion is seen across media outlets. In particular, there has been a significant rise in news outlets reporting on their health benefits. However, there is also rising concern about how digital media platforms communicate health solutions, particularly regarding accuracy and the under-reporting of potential risks.


Thus, Walker and Viaña set about to analyse how mindfulness apps were promoted in media and determine how academic evidence was utilised by the news media cycle.


Method


Walker and Viaña focused their study on two mindfulness apps, Calm and Smiling Mind. Both apps advocate for “mindfulness” as a coping mechanism for mental health issues and claim to provide a service to help support this. Both apps are also heavily promoted in the media.


To determine to what extent promotions of these apps use academic research to back up their claims, Walker and Viaña composed two lists. Firstly, a list of research articles mapping the available evidence on the health effects of these apps was collated using academic databases and the official websites of each app. In total, 16 papers were found to meet the requirements laid out by the authors, these all specifically mentioned Calm or Smiling Mind .


The authors then began investigating the media landscape, they collated a list of articles referencing apps to support mental health and wellbeing published within a six month period. These included newspaper and online news articles, blog posts, opinion pieces, letters to the editor and media releases, but excluded corporate and financial reports. In total, 105 articles explicitly referenced Calm or Smiling Mind.


A content analysis method was undertaken, mirroring previous approaches used to analyse the representation of health issues in media. The 16 research articles were used as a scoping review which, alongside discussions within the science communication academic field, informed the analysis method. This produced different “types of evidence” to analyse the content of the news articles against.


Results


Within the 105 articles promoting Calm or Smiling Mind, the authors found that four types of evidence were used to support the app's health claims. But for interest, I have separated "the personal experiences of the article author and interviewees" and "mentions of celebrity endorsements and collaboration" into two separate types. I also separated out "app-based studies" from the more general evidential type of "scientific research findings." This extends Walker’s and Viaña’s list to the following six types of evidence:

Type of evidence

The proportion of news articles which used this type to back one or more claim

Unsupported statements with no reference to any form of evidence


38%

Framing around the mental health experiences of celebrities and athletes or reporting on celebrity collaborations and content

41.9%

Personal experiences used as anecdotal evidence of health benefits

32.3%

Medical advice from an identified health professional

28.5%

Scientific research findings

5.7%

App-based scientific research findings

1.9%

This means 30 articles referred to the advice of “health experts,” and only eight articles referenced scientific research. Out of these eight, there were only two papers where the scientific research referred to app-based studies; the remaining six focused on the benefits of meditation generally.


The authors also collated data on how balanced a report the news articles gave. It was found that over 90% of articles purely mentioned app-based solutions, neglecting to mention any alternative treatments or any risks associated with using mindfulness.


Risky business

Walker and Viaña stated that it was “alarming” that only ten articles mentioned the potential risks of meditation or provided alternative treatments. They refer to case studies showing that meditation can have adverse results, such as depression, panic attacks and dissociation. And this risk isn’t low, with a 2019 study finding that a quarter of long-term mediators experience one or more of these adverse side effects. Consequently, Walker and Viaña suggest that omitting these risks from the news articles is an example of unbalanced reporting.


Furthermore, the lack of evidence support in the articles was correlated with a tendency to make generalised claims. This meant vague health benefits were often stated without mentioning who might benefit and to what extent, potentially leading to people with serious mental illness forgoing necessary medical care in place of mindfulness.


Nineteen of the articles referred to general mental health, six referred to depression, seven referred to anxiety, 22 referred to stress, and two referred to burnout. Walker and Viaña highlight how these are issues which can require significant social support to treat. However, these apps frame the treatment of these issues as the responsibility of the individual involved and no articles touched upon the social/structural problems that can impact mental health.


It is also important to note that a significant lack of diversity was found among participants in the list of collated research. 14 out of 16 studies that reported the racial composition of participants was predominantly White/Caucasian participants. Studies also mainly used female participants, accounting for at least 73% of the sample in those 14 studies. This limits the context in which the benefits of the apps are being researched, but these limitations were also not addressed in journalistic promotions.


Impact


Walker and Viaña demonstrate the disjoint between academic research and some journalistic endeavours, highlighting the alternative forms of “evidence” used in the mass media context. Anecdotal evidence is particularly interesting as it often highlights cases of systemic inequality, especially in healthcare. Furthermore, the prevalence of discussions of mental health support in the media is a step in the right direction, but these conversations need to be supported by research. Walker and Viaña highlighted a shocking number of news articles which included utterly unsupported claims.


New media shapes public discourse, and balance is essential. Readers need to look out for the type of evidence used in the media, and SciCommers have a role in ensuring balance in their work. Purely positively framed stories can influence the acceptance of new technologies. It is also essential to consider the diversity of readership and the context in which a finding is relevant. What works for one reader might be harmful to another. So next time you read about the new app that Shawn Mendes swears by to help him sleep, take a look and see if you can find any science within the article to back him up.


Edited by: Caroline Cencer & Niveen Abi Ghannam

Cover image credit: Emily Underworld via Unsplash


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