While it seems that there are an unlimited number of consumer-facing mobile apps for calorie counting/diets, exercise, menstrual calendars and symptom checking, Chilmark has been somewhat struck by the dearth of apps focusing on mood disorders.  Not sure why that is, but we were pleasantly surprised when Sad Scale showed up on the iPhone AppStore.  Having used this app several times now, Chilmark remains severely underwhelmed and it is arguably one of the worst apps we have demo’d.

A core tenet of Chilmark Research’s which contributes to our perspective on consumer-facing applications and technologies is:

“Health is Mobile”

Health does not happen when one sits down in front of a computer screen, health occurs everyday in every action a consumer takes.  This is in large part what the Robert Wood Johnson Foundation (RWJF) uncovered in their first round of research under Project HealthDesign (PHD). RWJF has taken the next step in round two funding of PHD now focusing grant funding on technologies that support “Observations of Daily Living” or ODLs.  Earlier this week, RWJF received over 100 proposals for the ODL grants.

Getting back to Sad Scale, this little iPhone app provides the ability to self-assess one’s mood in three specific categories, Depression, Post Partum Depression and Geriatric. For depression, Sad Scale uses the Zung Self-rating scale.  Post Partum uses the Edinburgh Postnatal Depression scale and Sad Scale does not reference the scale for Geriatrics, simply referring to it as “Geriatrics Scale.”  Each of these scales provide a list of questions that are automatically scored upon completion of the self-test.  Upon completion of the test, scores can be charted and also shared via email.

Very basic, simple straight forward app, so what’s not to like?

The app is nothing more than a series of questions on the iPhone and no effort has been made to leverage many of the rich features that the iPhone API offers.  It is a simple questionnaire ported to the iPhone – nothing more, and seemingly a lot less.

The color choices for text make it difficult to read some of the content presented.

At the end of the questionnaire, it has a link to resources but these are nothing but links to the home pages of sites like the Mental Health America, PostPartum.net or American Geriatrics Society.  Could not these developers at least take the user to some truly relevant content.  Seriously, is that the best these developers could find?

When someone is suffering a depressive episode they may balk at going through and answering a series of questions like this, especially all 20 questions under the Zung scale – when someone is depressed, it is often difficult for them to even get out of bed and get dressed, so why have them go through standard questionnaire that provides no personalization and quick feedback that is meaningful.

Some suggestions to improve this app?

How about we begin with the RWJF concept of ODL, let’s provide the consumer an opportunity to record their self-observations as it pertains to mood.  For example, how about a quick mood question, how do you feel right now, at this moment in time with a simple color wheel to express mood and make color a back-end quantifiable metric for clinicians.

What about a simple open-ended question that they can answer on why they are feeling they way they are? If needed, one could also have a question with a multiple choice of common triggers to answer, including “Other” with a fill-in the blank.

Also, it might be useful to have within the app a timer that can be set that asks the user what their mood is at that moment in time.  This may prove beneficial in understanding at what times of day the user is vulnerable to the mood disorder.

Provide some meaningful resources including direct links to relevant content.  Don’t make the user have to look for it on some website.

Now, I am no specialist in mood disorders and I am sure that there are other attributes that could be added to the app that might be helpful for the consumer and even possibly the clinician, but I have close family members who do suffer from depression and it is a severly debilitating disease and it does, at least from this vantage point seem ripe for an ODL platform.  Downloading Sad Scale I had hoped that this may be the beginning of something interesting.  Unfortunately, this was the most disappointing (dare I say depressing) health & wellness app downloaded off of the AppStore to date.  This is one sad app, that even at the paltry price of $0.99 is not worth it.