Effectiveness of Text Messages and Text Messages Plus Peer Support on Psychiatric Readmission and Length of Stay:...

Mental health recovery typically continues after patients leave the hospital. However, hospital readmission in the 12 months after discharge is common and costly.

This study aimed to examine the effectiveness of supportive text messaging (hereinafter "SMS") and SMS with or without peer support service on hospital readmission and length of stay after discharge from inpatient psychiatric care.

A stepped-wedge cluster randomized trial was used to examine differences in the changes in the mean number of admissions and the mean duration of total length of stay in days, for patients discharged from psychiatric inpatient care, at 6 and 12 months pre- and post index admissions, for 2 intervention periods compared to a control period of treatment as usual.

Overall, 1070 participants were assigned to 1 of 3 study arms: SMS (n=302), SMS with or without peer support service (n=342), or treatment as usual (n=426). Compared to treatment as usual, SMS with or without peer support service reduced hospital readmissions 6 months pre- and post index admission by an average of 0.26 admissions, and SMS alone reduced inpatient length of stays 6 months pre- and post index admission by an average of 7.28 days.

Our results demonstrate that simple, low-cost digital tools-either by themselves or paired with peer support-can help close gaps in postdischarge care. We anticipate that these findings may inform future service delivery models and policy development aimed at enhancing postdischarge mental health support. By supporting smoother transitions and reducing future hospital use, such approaches may offer a scalable way to build more sustainable and person-centered mental health systems.

ClinicalTrials.gov NCT05133726; https://clinicaltrials.gov/study/NCT05133726.