Does a mental health app still work without a coach checking in?

In a three-arm trial recruiting across 13 countries, 825 adults living with chronic medical conditions used a digital wellbeing program either on their own or with weekly phone check-ins. Both versions cut combined anxiety and depression scores by roughly 3 points versus a waitlist, and the two versions were statistically indistinguishable from each other.

Anxiety, depression and fatigue affect more than half of people living with long-term medical conditions, and one open question about digital mental health tools is how much a real human on the other end actually adds. This trial, run from February 2023 to December 2024 with online recruitment across 13 countries, randomly assigned 825 adults with self-reported chronic conditions to one of three groups: a waitlist, a self-directed program called eMPower (guided movement videos, breathwork, meditation, a coping-skills curriculum and disease education), or that same program plus a weekly phone call of up to 15 minutes from a trained non-clinician. After 12 weeks, the human-supported group improved by 2.9 points on the Hospital Anxiety and Depression Scale compared with the waitlist. The self-directed group improved by 2.6 points. The difference between the two intervention groups was not statistically significant on any outcome, and both beat the waitlist on fatigue and quality of life too. No intervention-related adverse events were reported. The honest caveat: the comparison group was a waitlist, which does not account for the simple effect of doing something and being watched, most diagnoses were self-reported, follow-up stopped at 12 weeks, and the sample skewed heavily female and highly educated.