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

Dror Ben-Zeev1, Benjamin Buck1, Suzanne Meller1

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Summary

Training community care teams as mobile interventionists using texting is feasible and promising for serious mental illness care. This approach improves patient outcomes and offers scalable support, especially when in-person contact is limited.

Keywords:
assertive community treatmentbipolar disorderdepressiondigital interventionsmHealthschizophrenia

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Area of Science:

  • Psychiatry
  • Digital Health
  • Mental Healthcare Delivery

Background:

  • Community mental healthcare teams play a vital role in supporting individuals with serious mental illness (SMI).
  • Traditional in-person interventions face challenges, particularly during public health crises like COVID-19.
  • There is a need for accessible, scalable, and patient-centered digital interventions.

Purpose of the Study:

  • To assess the feasibility and clinical utility of training psychiatric community care team members as "mobile interventionists."
  • To evaluate recovery-oriented texting exchanges as a method to engage patients with SMI.
  • To compare the mobile interventionist approach as an add-on to assertive community treatment (ACT) versus ACT alone.

Main Methods:

  • A 3-month pilot randomized controlled trial involving 49 individuals with SMI.
  • Comparison of mobile interventionist (texting) plus ACT versus ACT alone.
  • Evaluation of clinical outcomes at baseline, posttreatment, and 6-month follow-up; satisfaction assessed posttreatment.

Main Results:

  • The intervention was feasible (95% initiation, 69% texting days, 4 messages/day) and acceptable (91% satisfaction).
  • No adverse events were reported, indicating safety.
  • Exploratory analyses suggested greater reductions in paranoid thoughts and depression, and improved illness management and recovery in the mobile interventionist group.

Conclusions:

  • Augmenting care with texting mobile interventionists is feasible, acceptable, safe, and clinically promising for SMI.
  • The ease of training, low burden, and accessible technology support scalability.
  • Texting interventions are crucial for maintaining continuity of care, especially when in-person contact is restricted.