Peer + Text Message Support for Mental Illness

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

1132 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Peer support, Text4Support, Text4Support Program, Daily Supportive Text Messages for mental illness?

Research shows that supportive text messaging services like Text4Support can help people with mental health conditions after they leave psychiatric care. Additionally, digital peer support and text messaging interventions have been found to improve outcomes like medication adherence and social interactions in people with serious mental illnesses. ^{1 2 3 4 5}

Is peer and text message support for mental illness safe for humans?

The research suggests that supportive text messaging programs like Text4Support are generally safe for humans, as they are well-received by patients and do not report any adverse effects. These programs are designed to provide additional mental health support and have been positively evaluated in various studies. ^{3 6 7 8 9}

How does the Peer + Text Message Support treatment differ from other treatments for mental illness?

This treatment is unique because it combines peer support, which provides emotional and practical help from nonprofessionals, with supportive text messages, offering a low-cost, scalable way to maintain mental health after discharge from psychiatric care. This combination has shown to improve recovery rates and reduce psychological distress more effectively than either method alone or standard care. ^{3 10 11 12 13}

What is the purpose of this trial?

Avoidable hospital readmissions are a pressing problem for our healthcare system. They lead to substantial human suffering and higher financial costs. Most discharged psychiatric inpatients in Alberta are offered follow-up appointments with Alberta Health Services (AHS) Addiction and Mental Health (AMH) community providers. Patients often wait 28-38 weeks for their first appointment, which leads many to miss their first appointments, and increases the likelihood of relapse. As a result, patients discharged into the community are readmitted to the Emergency Department (ED). To address this significant revolving door, the investigators will implement a low-cost, evidence-based system that delivers daily supportive texts to patients' mobile phones. The text messages developed by experts and service users, based on cognitive behavioral therapy principles. Our proposed program also includes peer support from previous mental health patients who have had similar challenges as participants, but are now in recovery. In this way, the investigators aim to reduce the psychological treatment and support gap for AMH patients who have been discharged from acute care and are scheduled to receive mental health and psychiatric treatment from A\&MH services after a long wait. Our pilot test of these interventions provide evidence that psychiatric readmissions, and emergency department visits can be reduced by 10-25% if implemented at scale in Alberta, thus resulting in cost-savings for individuals and the province.

Research Team

Vincent Agyapong, MD,PhD

Principal Investigator

University of Alberta

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Augmenting Evidence-Based Care With a Texting Mobile Interventionist: A Pilot Randomized Controlled Trial. [2022]

2. United States 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. [2022]

3. Canada pubmed.ncbi.nlm.nih.gov

Patients' Expectations and Experiences With a Mental Health-Focused Supportive Text Messaging Program: Mixed Methods Evaluation. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Assessing a digital peer support self-management intervention for adults with serious mental illness: feasibility, acceptability, and preliminary effectiveness. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Telephone-based mutual peer support for depression: a pilot study. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Developing Texting for Relapse Prevention: A Scalable mHealth Program for People With Schizophrenia and Schizoaffective Disorder. [2020]

7. Switzerland 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. [2021]

8. Switzerland 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. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Short message service can be a promising tool for psychiatric patients and clinicians. [2015]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Clinical Outcomes in Routine Evaluation Measures for Patients Discharged from Acute Psychiatric Care: Four-Arm Peer and Text Messaging Support Controlled Observational Study. [2023]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Six-months outcomes of a randomised trial of supportive text messaging for depression and comorbid alcohol use disorder. [2018]

12. England pubmed.ncbi.nlm.nih.gov

A collaboration on teaching communication by text. [2022]

13. Canada pubmed.ncbi.nlm.nih.gov

Recovery Following Peer and Text Messaging Support After Discharge From Acute Psychiatric Care in Edmonton, Alberta: Controlled Observational Study. [2021]