Development and Implementation of Postdischarge Text Messages to Adolescents With Suicidal Thoughts and Behaviors...

Area of Science:

• Public Health
• Psychiatry
• Digital Health

Background:

• Youth suicide is a critical public health issue, with post-crisis care transitions posing elevated risks.
• Disruptions in care continuity and emotional support are common after suicidal crises.
• Caring contacts, particularly text messages, show promise in improving outcomes and patient engagement.

Purpose of the Study:

• To describe the development and implementation of automated caring contacts using supportive texts and images for adolescents post-discharge.
• To outline lessons learned, challenges, and success factors in a large pediatric hospital setting.
• To assess the feasibility and scalability of this intervention within a quality improvement framework.

Main Methods:

• A 3-phase implementation: content development, manual piloting and workflow assessment, and automated scaling with electronic health record integration.
• Development of supportive text messages and images focused on hope, inclusivity, and connection.
• Process outcome measures included staff compliance and optional patient post-text surveys.

Main Results:

• High patient engagement: 88.65% approached, 52.43% enrolled, and 94.92% completed the program.
• Key reasons for declining enrollment included lack of mobile phone access and caregiver preference.
• Surveyed patients reported increased hope (83%), feeling supported (87.9%), and desire for continued texts (86%).

Conclusions:

• Automated postdischarge caring contacts, incorporating images, were successfully scaled using quality improvement methods.
• The intervention proved effective and efficient, highlighting technology's role in enhancing care for at-risk youth.
• This approach offers a more accessible, inclusive, and sustainable suicide prevention strategy.