1. This mixed methods trial evaluated the efficacy of a texting-based mental health program for psychiatric outpatients.
2. Participants in the program reported high satisfaction and perceived impact regardless of sex or if they had depression or anxiety.
Evidence Rating Level: 2 (Good)
Long wait times, inability to take time off work, and need for transportation represent barriers to accessing outpatient mental health services. Accordingly, an increasing amount of technology-based mental health services are being developed. Texting-based programs allow for engagement of individuals who have a phone but may have limited or no access to data or wireless internet.
In this mixed methods study, a text-based mental health program (Text4Support) was compared to care as usual in psychiatric outpatients. Psychiatric outpatients aged 18-65 years old, who had a mental health condition, were able to provide written consent, and had a mobile phone capable of receiving text messages were included. Patients with substance use disorder were excluded from the study. The primary outcome measured was user satisfaction as measured by a survey. A subgroup of patients in the Text4Support group were also interviewed about their experiences.
A total of 181 patients were randomized to receive either Text4Support (n=89) or care as usual (n=92). The majority of participants were women (75%), white (89%), had completed postsecondary education (77%), and had either depression or anxiety (61%). Those in the Text4Support group reported improved stress levels (63%), less loneliness (66%), as well as increased hope (65%), mental wellbeing (69%), and quality of life (63%). The study was limited by sample size, inconsistent use of the Text4Support program, and use of a questionnaire that was not previously validated. Overall, programs like Text4Support represent a possible intervention for improving outpatient mental health.
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