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Mindfulness is part trillion dollar health industryrepresenting 1.5–6% of annual spending worldwide (estimated to be over US$200 million) about wellness products and services.

In particular, smartphone apps have skyrocketed in popularity, offering incredible mental health perspectives with wide coverage and scalability at a low cost. Mental illness was on the rise before the pandemic, but reached new heights during it. Accordingly, COVID created previously unseen demand for mindfulness apps and online courses.



Read more: What is Mindfulness? Nobody really knows and that’s the problem


It’s no surprise that people have turned to mindfulness after the last few stressful years and their significant promotions. And while there may be some benefit, it cannot treat mental illness on its own and should not be relied upon.

What does research say about mindfulness for mental health treatment?

Individual mindfulness programs such as stress reduction programs, which often include health information and guided meditation practice, show modest benefits among healthy people and people with mental illness.

People meditate in class
Personal mindfulness has been found to have some benefits.
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Among healthy people comprehensive review shows that mindfulness-based programs help most with symptoms of anxiety, depression, and distress and, to a lesser extent, improve well-being.

Among people with mental illness comprehensive review shows that mindfulness-based programs can help with anxiety and depressive disorders, as well as pain and substance use disorders. But mindfulness-based programs are not superior to standard talking therapy.

When it comes to structured online mindfulness programs (digital variations of programs like mindfulness-based stress reduction), review shows that the benefits are small but still significant for depression, anxiety, and well-being.



Read more: Can an app help us gain awareness in today’s busy high-tech world?


What about mindfulness apps?

Evidence for interventions using mobile phones and apps is less positive.

Recent comprehensive review interventions using mobile phones (including apps) pooled the results of 145 randomized controlled trials involving 47,940 people. The study looked at interventions and text messaging apps for a range of mental health conditions versus no intervention, minimal intervention (such as health information), and active intervention (other programs known to work). The authors “were unable to find strong evidence to support any mobile phone intervention in any outcome.”

One review The mindfulness apps included in the comprehensive review above found well-designed randomized controlled trials for only 15 of the hundreds of available apps. Overall results were mild to moderate for anxiety, depression, stress, and well-being. While these results seem positive, the majority of studies (about 55%) compared apps to doing nothing at all, with another 20% comparing apps to controls like audiobooks, games, relaxing music, or teaching math.

When applications are compared to well-established therapies, the results are often less promising. One study Comparing the mindfulness app to a “pretend” (something that looked and felt like mindfulness but wasn’t), the app was no better.

But does it do any harm?

Evidence shows that mindfulness meditation can actually make things worse for some people.

Recent meta-analysis which examined 83 studies of meditation, including 6,703 participants, found that 8.3% of people became anxious, depressed, or experienced negative changes in their thinking during or after meditation practice.

Stress Relief App
Most research shows that mindfulness apps provide little benefit.
Shutterstock

Another research suggests those first exposed to meditation through the app may be more likely to experience side effects such as anxiety, depression, or worse.

While apps and other forms of meditation are relatively inexpensive, if they don’t work, the return on investment will be low. While the costs may seem relatively small, they can represent a significant cost to individuals, organizations, and governments. The cost of some training modules and training programs thousand dollars.



Read more: We don’t fully understand what mindfulness is yet, but it’s what it isn’t


Mindfulness should be used “and also”, not “instead of”

Investing in these programs is not a problem in itself. Mindfulness meditation (including various digital offerings) has a significant potential. The problem is that mindfulness is not enough and should be used as an adjunct to first-line mental health therapies such as psychotherapy and medication, not instead of first-line treatment.

More worryingly, some mindfulness apps claim they can prevent mental health problems. So far, there is not enough evidence to make these claims.

In a world where people face multiple challenges, including social and income inequality, unprecedented environmental change, war, economic instability and global pandemics to name but a few, we must choose support programs very carefully.

While mindfulness may have some benefits for some people, it is not a substitute for first-line mental health treatment.

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