Bridging the Psychological Treatment Gap Using Peer Support and Supportive Text Messaging
Notice bibliographique
Résumé
Background: Most discharged psychiatric patients in Alberta are offered follow-up appointments with Alberta Health Services (AHS) Addiction and Mental Health (A&MH) community providers. It is typical to wait weeks or months for a follow-up appointment, resulting in a substantial psychological treatment gap. The significance of this treatment gap became more evident during the COVID-19 pandemic. Objectives: 1) Evaluate effectiveness of innovative peer support worker services (PSWs) and of supportive text messages (Text4Support) provided to the patients discharged from acute care, in Edmonton, Alberta.; 2) Implement and evaluate effectiveness of a supportive texting service (Text4Hope) provided to the general public during the COVID-19 pandemic; 3) Identify the prevalence of mental health conditions during this pandemic. Methodology: Through a prospective, rater-blinded, four-arm controlled observational pilot trial, we examined the use of PSS and text messages (TxM) of Text4Support for post-discharged patients from acute psychiatric care. Patients (n=181) with mental health disorder were recruited and randomised to either (1) PSWs alone; (2) PSWs + TxM; (3) TxM alone; or (4) treatment as usual (TAU). During the pandemic, we provided a three-month supportive TxM to the general public (Text4Hope) service to support and monitor mental health in Alberta. Validated self-report questionnaires were used to assess mental health conditions. Data were collected at baseline, program midpoint (6 weeks), and endpoint (12 weeks). Statistical analyses including descriptive, correlational, inferential statistics and longitudinal data analysis, using SPSS, and thematic analysis using NVivo software. Results: Sixty-five patients completed assessments at each time point of the pilot study. Improved scores were reported for PSW+TxM compared with TAU condition on the total recovery assessment score and willingness to ask for help and personal confidence and hope domains, along with environment domain (physical safety and security) of WHO-QOL scale, and the functioning domain of CORE-OM scale. The PSW+TxM group consistently achieved better outcomes on CORE-OM recovery, clinical and reliable improvement. TxM and PSW+TxM arms significantly reduced prevalence of risk of self/other harm symptoms after six-month intervention. After one-year of Text4Hope service, participants providing valid responses to baseline, six-week, and three-month surveys comprised groups of 9214, 4110 and 1286, respectively. Statistically significant reductions mid-point reductions were observed for likely prevalence and mean scores of moderate or high stress and likely anxiety but not likely depression. After 3 months of using Text4Hope, there were significant reductions of prevalence and mean score compared with baseline on: the GAD-7 by 22.7%, PHQ-9 by 10.3%, and PSS-10 scores by 5.7%. Similar reductions were reported after one year of the service, with the largest reduction in anxiety (32.9%). By the time of exiting the service, 89.4% subscribers reported high satisfaction with Text4Hope, and 60.6-85.7% agreed that the service helped them in diverse ways. Messages were read and well-perceived by more than 90% of the subscribers. Conclusions: Positive outcomes were reported after implementing PSW and TxM programs in terms of clinical and functional improvements, customer satisfaction; and effective surveillance methodology for tracing changes in mental health, during the COVID-19 pandemic. Free mobile-based services such as Text4Hope or Text4Support can overcome financial barriers, while maintaining essential physical distancing required during pandemics, and providing means of support for those with no access to conventional mental health services. This work indicates the potential value of incorporating such interventions in routine service.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».