The pandemic increased mental health needs. Some addressed it by building new apps.

The mental health toll of COVID-19 has been difficult for many, and traditional resources such as talk therapy have been overloaded in recent months.

As a result, developers and grassroots mental health organizations are trying to address the increase in need through behavioral health smartphone apps, which have been gaining popularity since even before the pandemic.

Headspace and Calm are popular meditation apps that have millions of users all over the world, and teletherapy apps such as Talkspace and BetterHelp have helped users connect with therapists. Last year, the American Psychological Association estimated that there are more than 10,000 mental health apps available to those in need.

Here’s how three Philadelphia-area mental health advocates and grassroots organizations built apps this last year to help young people tackle such issues as depression and anxiety.

Since its founding in 2014, Inner Strength Education has provided more than 15,000 students in Philadelphia high schools with trauma-sensitive resources and mindfulness programs. But much of their in-person instruction had to be reimagined when the pandemic sent the city into lockdown.

To keep in touch with students, the nonprofit built Inner Strength2, an app to help teens continue their mindfulness exercises at home, said Amy Edelstein, the founder and executive director of Inner Strength Education.

“A lot of students do go to technology for support,” she said. “We’ve developed tools to support focus, anxiety, self-love, self-care and positive affirmations. We’ve also been very careful to build in ways that students can pop out [of the app], so if they’re doing an exercise, and they find that they’re more agitated or a trauma that they’re dealing with is too overwhelming to engage with, they can do that.”

When students log in to the app, they complete a daily check-in, which asks them to assess their feelings on a scale of “sunny” to “stormy.” Next, they can choose to practice positivity through selecting self-affirmations such as “I am smart” or writing a journal entry about the things that they’re grateful for on that day. Students can also go through six brief meditation exercises using the app, such as breath work and stretching.

Since the app’s release in May, 250 users have signed up, Edelstein said.

“In Philadelphia, we’re seeing a lot of fear and agitation from the increase in gun violence,” she said. “We’re also seeing students really struggling from this year of instability due to the pandemic. Some students experienced loss, some experienced grief. We can’t underestimate the emotional and mental health challenges for teens moving forward, having lost that year and a quarter of social interaction.”

Inner Strength2 is available on iOS or through Google Play.

Peer Health Exchange, a national nonprofit that trains college student volunteers to teach a skills-based health curriculum to high schoolers in communities without comprehensive health education, also had to rethink its approach when schools closed last spring. The organization quickly prioritized preexisting plans to create an app.

Selfsea was developed with the input of eight high schoolers last summer, said Lisa Walker, the organization’s assistant vice president of programs and strategic learning.

“One of the main takeaways that they told us through the process was that they were not getting mental health education,” she said. “It was exactly the same thing we had heard a few years ago from people in our original focus group, that people just pretend mental health isn’t a thing. [The students] were really upset about that.”

The app focuses on centering students’ racial and gender identities and allows users to select issues they’re struggling with when they set up their profiles, such as addiction, body image, racism, sexual health and stress. Then, based on their answers, Selfsea shows users a video narrated by a student volunteer who reflects at least one part of their identity and what they’re struggling with.

“The videos feel really raw and like they’re having a conversation with the person,” Walker said. “They just dive into their personal story. And we try to keep it away from giving too much advice … it’s more like, ‘This is my experience and hopefully you’re able to feel supported through your experience.’”

The app also gives students a personalized list of “next steps” to get help. For example, those who selected body image as an issue might be prompted to create a positive mantra or read a list about healthier ways to look at their body compiled by the National Eating Disorders Association. Each resource has been vetted and recommended by a young person, Walker said.

Selfsea is a web app, but a final version is to be released later this summer for iOS and Android systems. A future version will also include closely moderated online communities for each mental health issue, so teens can connect with each other, Walker said.

“We see so many lists of resources out there,” she said. “Young people are very used to seeing that. But they aren’t as used to seeing why something is uniquely specific to their situation, and why it might be particularly helpful. So we’re trying to provide that link to those added, personalized resources rather than trying to recreate the wheel.”

www.selfsea.org

Like millions of Americans who suffer from an anxiety disorder, Alexandra Dodge knows just how debilitating it can be to experience symptoms of a panic attack such as a pounding heart, sweaty hands and nausea.

So when Dodge, a graphic and interactive design student at Temple University, was tasked with creating a digital product in a senior class last year, she decided to help those experiencing anxiety.

Dodge, 33, created a prototype of an app to track the physical signs of a panic attack through an Apple Watch and then guide users through simple exercises to manage those feelings. Her hope is to eventually make the prototype into an app available for users with the help of developers.

“I wanted something that would check in when it felt my heart rate increasing,” she said. “Because when you’re in an anxious situation, it’s really easy to sit there and deal with it until it gets bad. But when the app kicks in, the idea is that it reminds you, ‘Why don’t you take a minute?’”

Dodge, who lives near Phoenixville, designed the app, named rü anxiety forecast, for a class at Temple’s Tyler School of Art and Architecture that focused on the user experience (UX), user interface (UI), and branding of digital products. The app prompts users to focus on identifying the physical symptoms and specific emotions they are experiencing before offering suggestions that might help such as reading affirmations.

One of the main features of the app is “a circle that expands and contracts to mimic how long you’re supposed to breathe in and exhale,” she said. There’s also a musical component to help users time their breathing exercises. Studies have shown these exercises can reduce stress and distract from negative thoughts.

“Because [rü anxiety forecast] would be monitoring your heart rate, temperature, movements ... prompting you to go into a breathing exercise or some other form of meditation if it notices any kind of fluctuations would be more helpful and discreet for de-escalation in a public setting,” Dodge said. “This is kind of no frills, and the purpose of it, especially with the Apple Watch, was for it to be kind of discreet, like someone could look down at their wrist and follow guided breathing without any sound.”