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Background: Individuals exposed to wildfires are at risk of developing adverse mental health conditions in the months following the event. Receiving supportive text interventions during and after a wildfire event can have a significant impact on reducing mental health conditions over time., Objectives: The study aimed to assess the effectiveness of a supportive text message intervention service in reducing the severity and prevalence of psychological conditions 3 months following the 2023 wildfires in Alberta and Nova Scotia, two regions heavily affected by these natural disasters., Methods: In this longitudinal study, participants voluntarily subscribed to the Text4Hope-AB and Text4Hope-NS services, receiving supportive text interventions for 3 months. On enrolment and at 3 months post-enrolment, participants completed online surveys. The severity and prevalence of mental wellbeing, resilience, depression, anxiety, and post-traumatic stress were measured using the World Health Organization- Five Well-Being Index (WHO-5), Brief Resilience Scale (BRS), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder - 7 scale (GAD-7), and Post-Traumatic Stress Disorder Checklist for Civilians (PCL-C) respectively. Data analysis involved using McNemar's chi-square test and paired sample t -tests., Results: A total of 150 subscribers partially or fully completed both the baseline and 3-month assessments. The results show a statistically significant change in the mean scores on the WHO-5 Wellbeing Index (+ 24.6%), PHQ-9 (-17.0%), GAD-7 scale (-17.6%), PCL-C (-6.0%), and BRS (+3.2%) from baseline to 3 months. Similarly, there was a reduction, although not statistically significant, in the prevalence of low resilience (55.1 vs. 53.4%), poor mental well-being (71.6 vs. 48.3%), likely MDD (71.4 vs. 40.7%), likely GAD (42.1 vs. 33.3%), and likely PTSD (42.0 vs. 38.4%)., Conclusion: The study's findings underscore the potential of the supportive text intervention program in effectively aiding individuals who have endured natural disasters such as wildfires. Providing supportive text messages during wildfire events is a promising strategy for mitigating mental health conditions over time., Competing Interests: VA is the founder and Principal Investigator of the ResilienceNHope messaging programs and volunteers as the Board Chair of the Global Psychological eHealth Foundation, a not-for-profit organization. BA volunteers as the President and Chief Executive Officer of the Global Psychological eHealth Foundation. RS volunteers as the Program Director of the Global Psychological eHealth Foundation. RD volunteers as the Director of Communications of the Global Psychological eHealth Foundation. VA, BA, RS, and RD receive no financial or other compensation from the Global Psychological eHealth Foundation and have no financial conflicts of interest about this article. GO-D has no commercial or financial conflict of interest. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Obuobi-Donkor, Shalaby, Agyapong, Dias, Eboreime, Wozney and Agyapong.)

Background: The prevalence of major depressive disorder (MDD) poses significant global health challenges, with available treatments often insufficient in achieving remission for many patients. Digital health technologies, such as SMS text messaging-based cognitive behavioral therapy, offer accessible alternatives but may not reach all individuals. Email communication presents a secure avenue for health communication, yet its effectiveness compared to SMS text messaging in providing mental health support for patients with MDD remains uncertain., Objective: This study aims to compare the efficacy of email versus SMS text messaging as delivery platforms for supporting patients with MDD, addressing a critical gap in understanding optimal digital interventions for mental health care., Methods: A randomized noninferiority pilot trial was conducted, comparing outcomes for patients receiving 6-week daily supportive messages via email with those receiving messages via SMS text message. This duration corresponds to a minimum of 180 days of message delivery. The supportive messages maintained consistent length and structure across both delivery methods. Participants (N=66) were recruited from the Access 24/7 clinic in Edmonton, Alberta, among those who were diagnosed with MDD. The outcomes were measured at baseline and 6 months after enrollment using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the World Health Organization Well-Being Index (WHO-5)., Results: Most of the participants were females (n=43, 65%), aged between 26 and 40 years (n=34, 55%), had high school education (n=35, 58%), employed (n=33, 50%), and single (n=24, 36%). Again, most participants had had no history of any major physical illness (n=56, 85%) and (n=61, 92%) responded "No" to having a history of admission for treatment of mood disorders. There was no statistically significant difference in the mean changes in PHQ-9, GAD-7, and WHO-5 scores between the email and SMS text messaging groups (mean difference, 95% CI: -1.90, 95% CI -6.53 to 2.74; 5.78, 95% CI -1.94 to 13.50; and 11.85, 95% CI -3.81 to 27.51), respectively. Both supportive modalities showed potential in reducing depressive symptoms and improving quality of life., Conclusions: The study's findings suggest that both email and SMS text messaging interventions have equivalent effectiveness in reducing depression symptoms among individuals with MDD. As digital technology continues to evolve, harnessing the power of multiple digital platforms for mental health interventions can significantly contribute to bridging the existing treatment gaps and improving the overall well-being of individuals with depressive conditions. Further research is needed with a larger sample size to confirm and expand upon these findings., Trial Registration: ClinicalTrials.gov NCT04638231; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552095/., (©Medard K Adu, Oghenekome Eboreime, Reham Shalaby, Ejemai Eboreime, Belinda Agyapong, Raquel da Luz Dias, Adegboyega O Sapara, Vincent I O Agyapong. Originally published in JMIR Formative Research (https://formative.jmir.org), 09.09.2024.)

Background: Public safety personnel experience various mental health conditions due to their work's complex and demanding nature. There are barriers to seeking support and treatment; hence, providing innovative and cost-effective interventions can help improve mental health symptoms in public safety personnel., Objective: The study aimed to evaluate the impact of Text4PTSI on depression, anxiety, trauma, and stress-related symptoms, and the resilience of public safety personnel after six months of providing supportive text message intervention., Methods: Public safety personnel subscribed to Text4PTSI and received daily supportive and psychoeducational SMS text messages for six months. Participants were invited to complete standardized self-rated web-based questionnaires to assess depression, anxiety, posttraumatic stress disorder (PTSD), and resilience symptoms measured on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Brief Resilience Scale (BRS), respectively. The assessment of mental health conditions was conducted at baseline (enrolment) and six weeks, three months, and six months after enrollment., Results: One hundred and thirty-one subscribers participated in the Text4PTSI program, and eighteen completed both the baseline and any follow-up survey. A total of 31 participants completed the baseline survey and 107 total surveys were recorded at all follow-up time points. The baseline prevalence of psychological problems among public safety personnel were as follows: likely major depressive disorder (MDD) was 47.1%, likely generalized anxiety disorder (GAD) was 37.5%, low resilience was 22.2%, and likely PTSD was 13.3%. At six months post-intervention, the prevalence of likely MDD, likely GAD, and likely PTSD among respondents reduced; however, a statistically significant reduction was reported only for likely MDD (-35.3%, X 2 (1) = 2.55, p = 0.03). There was no significant change in the prevalence of low resilience between baseline and post-intervention. There was a decrease in the mean scores on the PHQ-9, GAD-7, PCL-C, and the BRS from baseline to post-intervention by 25.8%, 24.7%, 9.5%, and 0.3%, respectively. However, the decrease was only statistically significant for the mean change in GAD-7 scores with a low effect size (t (15) = 2.73, p = 0.02)., Conclusions: The results of this study suggest a significant reduction in the prevalence of likely MDD as well as the severity of anxiety symptoms from baseline to post-intervention for subscribers of the Text4PTSI program. Text4PTSI is a cost-effective, convenient, and easily scalable program that can augment other services for managing the mental health burdens of public safety personnel.

Background: Individuals discharged from inpatient psychiatry units have the highest readmission rates of all hospitalized patients. These readmissions are often due to unmet need for mental health care compounded by limited human resources. Reducing the need for hospital admissions by providing alternative effective care will mitigate the strain on the healthcare system and for people with mental illnesses and their relatives. We propose implementation and evaluation of an innovative program which augments Mental Health Peer Support with an evidence-based supportive text messaging program developed using the principles of cognitive behavioral therapy., Methods: A pragmatic stepped-wedge cluster-randomized trial, where daily supportive text messages (Text4Support) and mental health peer support are the interventions, will be employed. We anticipate recruiting 10,000 participants at the point of their discharge from 9 acute care psychiatry sites and day hospitals across four cities in Alberta. The primary outcome measure will be the number of psychiatric readmissions within 30 days of discharge. We will also evaluate implementation outcomes such as reach, acceptability, fidelity, and sustainability. Our study will be guided by the Consolidated Framework for Implementation Research, and the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. Data will be extracted from administrative data, surveys, and qualitative methods. Quantitative data will be analysed using machine learning. Qualitative interviews will be transcribed and analyzed thematically using both inductive and deductive approaches., Conclusions: To our knowledge, this will be the first large-scale clinical trial to assess the impact of a daily supportive text message program with and without mental health peer support for individuals discharged from acute psychiatric care. We anticipate that the interventions will generate significant cost-savings by reducing readmissions, while improving access to quality community mental healthcare and reducing demand for acute care. It is envisaged that the results will shed light on the effectiveness, as well as contextual barriers and facilitators to implementation of automated supportive text message and mental health peer support interventions to reduce the psychological treatment and support gap for patients who have been discharged from acute psychiatric care., Trial Registration: clinicaltrials.gov, NCT05133726 . Registered 24 November 2021., (© 2022. The Author(s).)