A Narrative Review of the Ethical Issues Concerning the Use of Self-HelpMobile Health Software in Mental Health: Future Perspectives

In developing countries, two-thirds of people do not have access to psychotherapy insurance services. Nowadays, self-help mental health software, without supervision by a therapist, has increased dramatically among the young. The present study has been conducted with the aim of reviewing the ethical issues concerning the use of self-help mobile-based healthcare software in mental healthcare.

In this narrative review, first, the articles indexed from 2000 to 2022 were searched in valid nationaland international databases: SID, PubMed, Science Direct, Web of Science and Google Scholar search engine. The keywords included e-health, mental health, intervention, software, internet, messenger,mobile phone, ethics, efficacyand self-help. Twenty-five articles were retrieved and reviewed. Then the ethical considerations were extracted and analyzed based on the four principles of biomedical ethics.

Ethical Considerations:

All ethical issues have been observed in this study, including unbiased citation, literature originalityand trustworthiness.

According to the current study, the ethical advantages of self-help mental health software include availability, anonymity, equality opportunity, immediate support, ease, attractiveness for the userand cost-effectiveness. They also have certain ethical disadvantages including the potential of being harmful, the need for internet literacy and access, ignoring the user's psychological characteristics, the user’s lack of ability to recognize when he/she may require higher levels of psychotherapy, the possibility of not taking enough therapy sessions, the users’ lack of skill in choosing the proper softwareand the inadequate management of treatment motivation.

Due to the potential of mental harm, this software must be used with the help and under the supervision of therapists. Personalization in the design of these software in accordance with the user's needs, cultural compatibility, moving towards game therapy, as well as determining its effectiveness by therapists are among the leading perspectives in this regard