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When mental health apps become worry engines: how digital ‘care’ can hijack our anxieties

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It’s 2:47 am and your phone buzzes on the nightstand. The notification suddenly glows in the darkness: “You’re on a 7-day streak!”; “Don’t break your streak!”. You feel the need to open the app right away for an emergency breathing exercise. Half-awake, you fumble for the device, chest tightening. Another buzz: “What’s your positive intention for the day?”

The app that promised to ease your anxiety has just jolted you into a state of micro-panic. Have you fallen prey to some kind of toxic, digital positivity?

Research shows that smartphone notifications from various types of apps can contribute to stress, anxiety and depression, with users receiving dozens of push notifications daily.

A recent meta-analysis found that while mental health apps can help improve clinical outcomes, there are some concerns around too much engagement leading to frustration and stress.

These apps, sometimes marketed as “therapist in your pocket” and “a sort of 24-7 mobile therapist” are employing strategies closely resembling what social media platforms use to maximise psychological engagement. But when the product is mental wellbeing, what happens when the cure becomes part of the disease?

To understand why app design choices matter, we need to consider how our minds process threats, whether positively or negatively framed. In my new book Framing – The Social Art of Influence, I examine topics ranging from caviar ads to public‑health campaigns, asking which kinds of signalling strike a chord with different audiences in particular situations. While mental‑health apps are not directly investigated in my book, there are plenty of parallels to them backed up by research.

One key idea is the distinction between “rough” and “smooth” textures of framing in communication. Rough framing uses threat cues, surveillance language and urgency to capture attention. It’s the difference between a gentle reminder and a fire alarm. These apps systematically deploy rough framing through their notification systems.

Consider how these notifications exploit what evolutionary psychologists call our “hypervigilance bias” — the ancient tendency to overreact to potential threats that once kept our ancestors alive. Research shows that throughout human evolution, diverse environmental threats shaped our brain’s fear response, resulting in cognitive mechanisms that prioritised survival.

When an app warns that your stress is spiking, it’s using the same neural pathways that once alerted us to predators. But unlike a rustling bush that might hide a tiger, these digital warnings can create threats where none existed.

By sending alerts about “detected stress” or “mood dips,” mental health apps create micro-crises that only the app can resolve. User reviews consistently praise the “instant reassurance” these apps provide, yet studies tell a different story about long-term engagement patterns.

Research on mental health app notification timing and frequency reveals concerning patterns. One study found that people using a certain app receiving daily notifications showed higher engagement initially. Still, some users described experiencing frustration with repetitive notification content, with one participant noting: “n the end it got me a bit annoyed, ‘cause I was like, ‘Oh, I’ve done this already.’”

Analysis of push notifications showed that frequent users become less responsive to suggestion-based prompts over time.

Hot and cold framing

In my book’s framework of social influence, I also distinguish between “hot” and “cold” framing temperatures. Hot framing creates urgency and emotional intensity — think breaking news alerts or emergency warnings. Cold framing allows space for reflection and considered response.

Mental health apps have become masters of hot framing. Haptic buzzes accompany streak warnings. Red badges accumulate on home screens. Animation effects show wilting flowers when you miss a meditation session. One popular app even sends notifications styled like text messages: “Hey! Your anxiety score is climbing. Let’s chat?”

The informal tone masks the manipulative design — you’re not chatting with a friend but with an algorithm optimised for engagement.

This matters because mental health recovery often requires the opposite approach. Decades of research in cognitive behavioural therapy emphasise the importance of creating distance from anxious thoughts, not constant monitoring of them. When we’re repeatedly prompted to check our stress levels, we’re training ourselves to become more, not less, aware of every physiological fluctuation.

How to improve design

The solution isn’t to demonise technology or abandon digital mental health tools altogether. Instead, we need to reframe how these apps operate radically. Research suggests several promising approaches that shift from hot to cool, rough to smooth framing.

Woman doing guided yoga with her laptop.

Mental health apps can be helpful – when used in the right way.
Ground Picture/Shutterstock

First, notification caps work. A study on smartphone notification batching found that limiting alerts to three times daily reduced stress and increased wellbeing. Moreover, research on mental health app notifications warns that “a lot of annoying reminders can lead to disengagement” and recommends allowing users to customise reminder frequency and timing.

Second, opt-in rather than default biometric monitoring reduces the surveillance feel while maintaining functionality for those who genuinely benefit. Third, what designers call “intentional friction” — small barriers to obsessive checking — can break compulsion cycles. Such barriers may include limiting how often data is refreshed or using batching notifications.

Colour psychology matters too. Research on healthcare design shows that blue environments can lower blood pressure, reduce heart rate and decrease cortisol levels. A study on mental health app design found that young people “favoured a subtle use of colour” for wellbeing apps, warning against “overly intense colours”.

Language shifts make a difference. “When you’re ready, you might enjoy a breathing exercise” lands differently than “URGENT: Manage your stress NOW!”

What you can do

The next time your mental health app sends an urgent notification, pause before responding. Ask yourself: is this alert serving my wellbeing or the app’s engagement metrics? Are these “insights” about my stress creating more worry than wisdom? The power to reframe these digital interactions lies first in recognising how they frame us.

Perhaps the most radical act of digital self-care is the simplest: turning off notifications altogether. True mental wellness might begin not with another app alert, but with the confidence to trust our own minds, in their own time, at their own pace. Now that would be revolutionary — an app that knows when to stay quiet.

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Labour’s plan to revitalise high streets is good – now it has to make sure people hear about it | Morgan Jones

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The government has launched its Pride in Place strategy, which sees significant investment in disadvantaged communities across the country. It is also, says the newly minted housing, communities and local government secretary, Steve Reed, “putting working families in control of their lives and their neighbourhood”. This follows the English Devolution and Community Empowerment bill, which ploughs a similar furrow, legislating for, among other things, communities’ right to buy and ensuring sports venues are automatically listed as assets of community value.

The strategy is being broadly understood as Labour’s answer to Boris Johnson’s much-touted “levelling up”. The investment, Keir Starmer has said, will “get rid of the boarded-up shops, shuttered youth clubs and crumbling parks that have become symbols of a system that stopped listening”. Neighbourhoods and high streets are the place where the “change” promised by Labour’s winning manifesto must first manifest. It’s not all about the fastest-growing GDP in the G7: the strategy starts by asserting that the government’s “measures of success cannot just be shifts in national statistics but must include change that people see and feel in their local community”.

Labour MPs are praising the direct investment the fund will bring to their communities. The funding allocations have been decided by, among other things, the index of multiple deprivation and the lesser-known community needs index, which measures quality of available services. When communicating the policy to their constituents and local media, they are generally leading with the cash amount being funnelled into their areas, as well they should. Money is what makes things real: policies about duties and responsibilities that cost nothing are cheap in all senses of the word.

People working in what might be understood as the “progressive communitarian” space (including organisations such as Power to Change, the Independent Commission on Neighbourhoods, Locality and the Co-operative party) want to critique that narrative, however. They argue that Labour’s plans are different from the levelling-up funds because of the structures by which the money will be spent. It provides money and power.

“Nothing destroys political trust like money that comes and goes,” says Caitlin Prowle, head of politics at the Co-operative party, drawing a direct contrast with Johnson’s plan: “This isn’t just about investment in communities, it’s about a genuine shift in power and ownership. This money comes with new powers to shape and own community assets, so that even when funding fades, the community owns those places and can determine their future.”

As with the provisions of the English Devolution and Community Empowerment bill (but more so), it is being framed by Labour as a response to decreasing trust in politics – and, of course, to Reform UK. Farage’s party placed second to Labour in a great many of the areas that will now receive funding. “This is our alternative to the forces trying to pull us apart,” says Reed in his introduction to the strategy. There are no prizes for guessing who he means.

The theory of change here is based on ideas about political trust, understanding Reform as a manifestation of anti-politics. First, it argues that people want to see real delivery in their local areas – and that at this level it is possible to give it and make people believe politics is responsive to their lives. Second, it seeks to build up trust and positive feeling, from where it is strong at a local level, so that its benefits might apply to national politics.

Steve Reed is a Labour and Co-operative MP, and before entering parliament was leader of Lambeth council, in which time he set up the Co-operative Councils Innovation Network. In 2011, in his contribution to the Purple Book (an attempt at intellectually revitalising the Labour right after the 2010 defeat, featuring contributions from no fewer than five current cabinet ministers), he wrote about “handing more power to communities and the people who use public services”, something which requires turning the “traditional model upside down”.

Reed is a long-term believer in the politics he is now attempting to put into practice; this background probably goes some of the way to explaining why this programme is the most fleshed-out iteration of Labour’s localism-against-Reform playbook thus far. Whether it is successful, however, depends on how well Labour can communicate the agenda and authentically own the changes that will be brought about by this shift of money and power. Reform is, many people acknowledge, significantly ahead of Labour when it comes to community organising (something no doubt due in part to the difficult legacy of the Corbyn-era Labour community organising unit, shuttered early in the Starmer years, which became for many on the then ascendent right of the party a byword for a kind of lefty excess that was both out of touch and insufficiently electorally minded). But the potential rewards are huge: a rebuke to the argument that politicians are removed from people’s real lives, and an injection of cash and autonomy to places that sorely need both.

  • Morgan Jones is the co-editor of Renewal: A Journal of Social Democracy

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Madeline Horwath on AI chatbots and cognitive decline – cartoon

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Most of gen Z watch TV with the subtitles on – and I understand why | Isabel Brooks

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I used to think there were two types of people: the ones who only use subtitles when necessary, and the unappreciative philistines who use them for no good reason. I was willing to die on this hill, arguing that they distracted from the purity of the audiovisual experience: the cinematographer’s attention to detail, the glimpse of a tear in an actor’s eye, the punchline of an expertly timed joke, and so on.

But I have been forced to recognise just how alone I am on this hill: in 2021, a survey found that 80% of 18-25-year-olds used subtitles all or some of the time, while a new survey run by streaming service U found that 87% of young Britons are using subtitles more than they used to. There is no longer a debate about subtitles: among my peers, “two types” of people have given way to “mostly one type”. (Meanwhile, the 2021 survey found that less than a quarter of boomers used subtitles, despite the latter generation experiencing more hearing difficulties overall.)

Why is this practice so common among people my age? If you aren’t hearing-impaired and are fluent in the language of the dialogue, what is it about subtitles that makes them more appealing?

An easy assumption is that this is the result of a short attention span, passivity and a lazy nature, a failure of generation Zombie. But having experienced watching TV with and without subtitles, I’d say the former doesn’t beget lazy viewing so much as a quicker information download. The new status quo of “subtitles on” among the young reflects both a values shift and cultural conditioning as a result of big tech’s ever-encroaching impact on our entertainment experience.

For example, the small screen in our living room has to share the limelight with the micro screen in our lap. The U survey revealed that 80% of gen Z and millennials “double-screen” when they watch. With subtitles on, I find myself being able to quickly gather what one character has said, look down at my phone, react to a message, then look up before that character has even finished their line. The viewing experience thus becomes multifaceted and efficient. The subtitles allow us to go on our phone but still absorb the content and gist of the TV show. Of course, that means they also function as mini-spoilers: when watching a comedy sketch recently, I found myself half-heartedly chuckling at a joke before it had left David Mitchell’s mouth – because I had already read it on the screen.

I don’t need to use my little grey cells when watching most TV shows, but there are few, like Succession, where double-screening is a sad exercise. Even if I manage to successfully absorb each line in the script through reading, I’d be neglecting the exceptional acting. The same thing cannot be said for Love Island (although arguably the acting is of a high standard there, too).

And social media itself has encouraged the use of subtitles across the board. It is now a given that most creators add text captions to their videos – without the option to turn them off. This cultural shift may explain the generational gap between boomers and younger viewers, the latter only appeased by rapid-fire content and videos with faster cuts, absorbing lightweight content at a higher speed, which text captions allow us to do.

This isn’t simply a trend but a feature anchored in the algorithm itself. Text captions, rather than dialogue, encourage the video to crop up in the TikTok search engine, increasing reach and visibility as well as viewer retention and viewing time. It began as an accessibility improvement, but the rapidity with which it has caught on suggests it’s business-oriented and crucial to getting that sweet algorithm boost. The fact that 85% of social media visual content is now watched on mute (while commuting, cooking, on the treadmill at the gym or in houseshares), coupled with the ease with which AI can generate subtitles without the need for human transcription, means we’re living in a subtitled world – one that is often poorly translated, low-quality and error-ridden.

Seen this way, subtitles have been normalised as a result of our technology-infused lifestyle, rather than being something we have actively sought out or freely adopted. My flatmate, a keen TikToker, said she used to find subtitles distracting and annoying, then gradually started using them while watching TV. “I’ve felt very passive in it,” she said. “I don’t think I look at them most of the time.” Then why do you have the subtitles on, I asked. “I don’t know,” she said with a shrug.

Amazingly, subtitles have not been linked to improvements in young people learning to read, although other studies have shown that they can improve comprehension of what happened in a given programme. Subtitles arguably keep us following more effectively than non-subtitles. Our TV habits are now influenced by a need for efficiency ported over from our social-media habits, which mean we can quickly glean the necessary content and then move on. In a 2023 survey, 40% of Americans cited “enhanced comprehension” as the main reason they use subtitles.

I have to ask: are people now watching shows just to find out what happens, and to prove they’ve seen it? Since when did we finish work, sit down on the sofa, cuddle up and think “thank god, I can’t wait for a bit of comprehension tonight”? TV is supposed to be fun. Shouldn’t we be focused on enjoying it?

  • Isabel Brooks is a freelance writer

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