Peer + Text Message Support for Mental Illness

Not currently recruiting at 6 trial locations

Overseen By Vincent Agyapong, MD, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alberta

Disqualifiers: Addiction disorder, Illiteracy, Travel, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 24

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether daily supportive text messages and peer support can reduce the likelihood of individuals with mental health issues needing emergency care again after hospital discharge. The trial aims to bridge the gap during long wait times for follow-up appointments by providing mental health support through text messages based on cognitive behavioral therapy (a therapy that helps change negative thought patterns) and peer support from those who have overcome similar challenges. To evaluate the effectiveness of this approach, some participants will receive only text messages (Text4Support), while others will receive texts plus additional peer support. This trial suits individuals diagnosed with a mental health condition, set to be discharged from acute care, and who have a mobile phone capable of receiving texts. As an unphased trial, this study offers a unique opportunity to access innovative support methods that could enhance mental health journeys.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on providing additional support through text messages and peer support, so you may not need to change your medication routine.

What prior data suggests that this program is safe for mental health patients?

Research has shown that supportive text messaging programs are safe for people with mental health conditions. Previous studies have examined the impact of daily text messages on mental health, finding no evidence of harm. In fact, some studies have found they can help reduce feelings of distress. However, results can vary, especially for conditions like depression and anxiety.

Regarding peer support, research indicates it is safe and helpful for people with mental health issues. Peer support involves receiving help from individuals who have faced similar challenges. Studies suggest it can increase feelings of social connection and empowerment, with no major safety concerns reported.

Both text messaging and peer support have been used safely in various settings. While results can differ, strong evidence indicates these approaches are generally well-tolerated. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for mental illness because they incorporate innovative methods like peer support and text messaging. Unlike traditional therapies such as medication or face-to-face counseling, these approaches offer ongoing, real-time support that can seamlessly integrate into a person's daily routine. The use of daily text messages provides consistent encouragement and information, while the option of peer support adds a personal touch by connecting individuals with someone who has shared experiences. This combination has the potential to enhance accessibility and engagement, providing a unique, supportive environment that can complement existing care options.

What evidence suggests that this trial's treatments could be effective for reducing psychiatric readmissions?

Research has shown that Text4Support, a program sending supportive text messages, can improve mental health. Studies have found it reduces stress, anxiety, depression, and even suicidal thoughts. In this trial, one group will receive only the Text4Support program, while another group will receive Text4Support with some participants also receiving peer support. Peer support programs, where individuals assist each other, effectively help those with serious mental health issues by reducing hospital stays and aiding recovery. Combining daily texts with peer support might lead to fewer hospital readmissions and better mental health. This method offers a promising way to provide extra mental health support after hospital discharge. ^{1 4 6 7 8}

Who Is on the Research Team?

Vincent Agyapong, MD,PhD

Principal Investigator

University of Alberta

Are You a Good Fit for This Trial?

This trial is for adults aged 18 to 65 who are being discharged from acute psychiatric care, have a mental health diagnosis, can consent to participate, and own a mobile device that can receive texts. It's not for those with addiction disorders without a mental health diagnosis or who cannot read texts.

Inclusion Criteria

Patients should have a mobile device capable of receiving text messages

I can sign consent, have a mental health diagnosis, and am ready to leave the hospital.

Able to provide informed written consent have been diagnosed with mental health condition, and are ready for discharge

Exclusion Criteria

Patients will be ineligible if they do not meet the above inclusion criteria

Patients are also ineligible if they do not consent to take part in the study

Are not capable of reading text messages from a mobile device or if they know they will be out of town during the 12-month follow-up period

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive daily supportive text messages and optional peer support for six months

24 weeks

Daily text messages, optional peer support sessions

Follow-up

Participants are monitored for changes in clinical outcomes and readmission rates

28 weeks

Assessments at baseline, 24 weeks, and 52 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Peer support
• Text4Support

Trial Overview The study tests whether daily supportive text messages based on cognitive behavioral therapy principles and peer support by recovered patients can reduce hospital readmissions among recently discharged psychiatric patients awaiting follow-up treatment.

How Is the Trial Designed?

Group I: Text message with or without peer support Experimental Treatment 2 Interventions

All individuals in this cluster will receive daily text message support for six months plus weekly text message over 6 weeks (six information text messages all together) with some selected members also receiving peer support for six months

Group II: Text Message cluster Experimental Treatment 1 Intervention

This arm will receive only daily text message support for six months plus weekly text message over 6 weeks (six information text messages all together)

Group III: Control group Active Control 1 Intervention

This group will only receive usual care plus weekly text message over 6 weeks (six information text messages all together) with provides information about community services

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials

957

Recruited

437,000+

Alberta Innovates Health Solutions

Collaborator

Trials

54

Recruited

94,100+

Published Research Related to This Trial

The PeerTECH intervention, a digital peer support program for adults with serious mental illness, was found to be feasible and acceptable, showing significant improvements in self-efficacy and personal empowerment over a 12-week period with 21 participants.

Preliminary evidence suggests that this intervention can enhance self-management skills for both medical and psychiatric conditions, indicating its potential as a valuable tool in supporting recovery for individuals with serious mental illnesses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing a digital peer support self-management intervention for adults with serious mental illness: feasibility, acceptability, and preliminary effectiveness. Fortuna, KL., Myers, AL., Ferron, J., et al.[2023]

The study demonstrated that training community care team members to act as mobile interventionists for texting support is feasible and safe, with 95% of participants engaging in the intervention and no adverse events reported.

Participants receiving the mobile intervention showed promising clinical improvements, including significant reductions in paranoid thoughts and depression, suggesting that this approach could enhance recovery for individuals with serious mental illness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Augmenting Evidence-Based Care With a Texting Mobile Interventionist: A Pilot Randomized Controlled Trial. Ben-Zeev, D., Buck, B., Meller, S., et al.[2022]

The Mobile Assessment and Treatment for Schizophrenia (MATS) program, which used text messaging over 12 weeks, significantly improved medication adherence and social interactions, particularly for individuals living independently.

Participants also experienced a notable reduction in the severity of auditory hallucinations, indicating that low-intensity interventions like MATS can effectively enhance outcomes for higher functioning individuals with schizophrenia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobile Assessment and Treatment for Schizophrenia (MATS): a pilot trial of an interactive text-messaging intervention for medication adherence, socialization, and auditory hallucinations. Granholm, E., Ben-Zeev, D., Link, PC., et al.[2022]

Patients often feel vulnerable when accessing community mental health programs, leading to low adherence and dissatisfaction with treatment, which can result in recurrent hospitalizations.

The proposed Text4Support service, based on cognitive-behavioral therapy principles, aims to improve mental health outcomes and patient satisfaction for those attending or discharged from psychiatric care, potentially reducing the burden on the health care system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Augmenting Mental Health Support for Patients Accessing Different Degrees of Formal Psychiatric Care through a Supportive Text Messaging Program: Protocol for a Randomized Controlled Trial. Dias, RDL., Shalaby, R., Agyapong, B., et al.[2023]

The Text4Hope service, which provided daily mental health text messages for six weeks, significantly reduced levels of moderate/high stress, generalized anxiety disorder (GAD), and major depressive disorder (MDD) among its subscribers compared to those who had not yet received messages.

Participants in the intervention group reported a 20.9% improvement in overall mental health scores, demonstrating that Text4Hope is an effective tool for alleviating mental health issues during the COVID-19 pandemic and suggesting that similar services could be beneficial in future crises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental Health Outreach via Supportive Text Messages during the COVID-19 Pandemic: Improved Mental Health and Reduced Suicidal Ideation after Six Weeks in Subscribers of Text4Hope Compared to a Control Population. Agyapong, VIO., Shalaby, R., Hrabok, M., et al.[2021]

SMS (text messaging) is a widely accessible communication tool that can be effectively utilized for health-related messaging, particularly in mental health care.

Technology-delivered interventions like SMS can support mental health patients in their treatment and recovery, providing a valuable resource for both patients and clinicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short message service can be a promising tool for psychiatric patients and clinicians. Vernig, PM., Repique, RJ.[2015]

The Text4Support service, which provides supportive text messages to patients after discharge from psychiatric care, was well received by 40% of participants who reported high satisfaction with the service's impact on their mental well-being.

Participants suggested that future iterations of the service could benefit from more personalized messages and opportunities for interaction with healthcare personnel, indicating a desire for enhanced engagement in their mental health support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patients' Expectations and Experiences With a Mental Health-Focused Supportive Text Messaging Program: Mixed Methods Evaluation. Shalaby, R., Vuong, W., Eboreime, E., et al.[2022]

A telephone-based mutual peer support intervention for individuals with ongoing depressive symptoms was found to be feasible and acceptable, with 59.3% of the 54 participants completing the 12-week program.

Participants who completed the intervention showed a significant reduction in depression symptoms, with an average decrease of 4.2 points on the BDI-II scale, along with improvements in quality of life and psychological health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telephone-based mutual peer support for depression: a pilot study. Travis, J., Roeder, K., Walters, H., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11203176/

Effectiveness of Peer Support Programs for Severe Mental ... This study aimed to systematically review and meta-analyze the forms and effectiveness of peer support programs for individuals with severe mental illnesses.

2. psychiatryonline.org psychiatryonline.org/doi/10.1176/appi.ps.202100138

The Effectiveness of Peer Support in Personal and Clinical ... The authors reviewed the effectiveness of peer support for both personal recovery and clinical recovery of adults with any mental illness.

3. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02923-3

The effectiveness of one-to-one peer support in mental health ... One-to-one peer support in mental health services might impact positively on psychosocial outcomes, but is unlikely to improve clinical outcomes.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10038377/

The effectiveness of peer support from a person with lived ... Trachtenberg (2013) [20] found that peer support significantly reduces hospital bed use, with the average financial savings outweighing ...

5. mhanational.org mhanational.org/peer-support-research-and-reports/

Peer support: Research and reports Mental Health America has compiled a database of current research related to the support of peers as a needed and beneficial paid services in mental health ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12254959/

The “Paths to everyday life” peer support intervention for ... Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process.

7. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03321-z

A systematic review and meta-analysis of group peer support ... We found evidence that group peer support may make small improvements to overall recovery but not hope or empowerment individually, or to clinical symptoms.

8. cambridge.org cambridge.org/core/journals/the-british-journal-of-psychiatry/article/effectiveness-of-peer-support-for-people-with-severe-mental-health-conditions-in-high-middle-and-lowincome-countries-multicentre-randomised-controlled-trial/12B11F541341A894771EE76B7695F4B9

Effectiveness of peer support for people with severe mental ... Peer support has beneficial impacts on social inclusion, empowerment and hope among people with severe mental health conditions across diverse settings.