OBJECTIVE: This study aimed to evaluate the feasibility and clinical utility of training intensive psychiatric community care team members to serve as `` mobile interventionists '' who engage patients in recovery-oriented texting exchanges .
METHODS: A 3-month pilot randomized controlled trial was conducted to compare the mobile interventionist approach as an add-on to assertive community treatment (ACT) versus ACT alone . Participants were 49 individuals with serious mental illness (62% with schizophrenia/schizoaffective disorder , 24% with bipolar disorder, and 14% with depression). Clinical outcomes were evaluated at baseline, posttreatment, and 6-month follow-up, and satisfaction was evaluated posttreatment .
RESULTS: The intervention appeared feasible (95% of participants assigned to the mobile interventionist arm initiated the intervention, texting on 69% of possible days and averaging four messages per day), acceptable (91% reported satisfaction), and safe (no adverse events reported). Exploratory posttreatment clinical effect estimations suggested greater reductions in the severity of paranoid thoughts (Cohen's d=-0.61) and depression (d=-0.59) and improved illness management (d=0.31) and recovery (d=0.23) in the mobile interventionist group .
CONCLUSIONS: Augmentation of care with a texting mobile interventionist proved to be feasible, acceptable, safe, and clinically promising . The findings are encouraging given the relative ease of training practitioners to serve as mobile interventionists, the low burden placed on patients and practitioners, and the simplicity of the technology . The technical resources are widely accessible to patients and practitioners, boding well for potential intervention scalability . When pandemics such as COVID-19 block the possibility of in-person patient-provider contact, evidence-based texting interventions can serve a crucial role in supporting continuity of care.