Text Messaging for Psychiatric Outpatients: Effect on Help-Seeking and Self-Harming Behaviors

Abstract

A mobile phone intervention was developed and tested with 30 psychiatric outpatients with mental illness, who had high ideation for suicide. The intervention involved promoting helpseeking behaviors by sending text messages, including information about social welfare services and reminders about medical appointments, for 6 months. After the intervention period, the number of participants who used social services significantly increased, and more than 80% of participants reported that the text messaging service was helpful and useful. Compared to baseline, participants' self-harming behaviors decreased and the attending psychiatrists rated their suicide ideation as weaker. This is the first intervention study to promote psychiatric patients' help-seeking using text messaging, and although it was not a randomized controlled trial, this intervention has practical value and may lead to the prevention of suicide.

A Systematic Review of the Evidence Supporting Mobile‐ and Internet‐Based Psychological Interventions For Self‐Harm

“…Nine used mobile phone applications to deliver a toolbox of support including coping skills and strategies (often derived from approaches such as CBT and DBT) as well as signposting or crisis support (Bush et al., , ; Kennard et al., ; McManama O'Brien, LeCloux, Ross, Gironda, & Wharff, ; O'Toole, Arendt, & Pedersen, ; Pauwels et al., ; Rizvi, Hughes, & Thomas, ; Stallard, Porter, & Grist, ; Tighe et al., ). Three interventions involved supportive text messages (Berrouiguet, Gravey, Le Galudec, Alavi, & Walter, ; Chen, Mishara, & Liu, ; Kodama et al., ). One intervention involved the use of audio and text messages relating to coping skills and strategies, which followed on from face‐to‐face support (Marasinghe et al., ).…”

“…Self‐reported acceptability was good where assessed ( k = 13). For text message‐based services, participants in three studies found the interventions to be helpful (80%–93%), and a good way to stay in touch with services (93%; Berrouiguet et al., ; Chen et al., ; Kodama et al., ). However, in one of these studies participants were more divided around whether the service benefited their psychological health, and suicidal thoughts or behavior (40%–60% felt the service was helpful in these areas; Berrouiguet et al., ).…”

Gateless communication: A concept analysis

“…Another implication of time‐delay between communication is the risk that a medication dose or medical intervention is overlooked and not performed at the ideal time. In addition, in behavioral health, time length between provider feedback can result in risky behavior like self‐injury or suicide …”

“…This is to accommodate patient needs to get in contact with their providers in real‐time. Several studies have examined how this practice is being used; though, the literature is scant in its impact on healthcare outcomes . It is necessary to consider the efficacy of this type of instantaneous communication and whether it is beneficial for the long‐term treatment of diseases .…”

“…Several studies have examined how this practice is being used; though, the literature is scant in its impact on healthcare outcomes. [6][7][8] It is necessary to consider the efficacy of this type of instantaneous communication and whether it is beneficial for the long-term treatment of diseases. 9 The concept of "gateless communication" is proposed to help conceptualize the practice of direct patient to provide information sharing.terms of the concept are defined as "gate-a means of entrance" and "communication-the essence of human interaction and learning."…”