2019 Finalist: Outstanding Achievement in Health Innovation
Text4Mood delivers easy access to mental health supports
Long wait times and geographical barriers are common problems facing Albertans trying to access counselling for addiction and mental health issues. Dr. Vincent Agyapong developed Text4Mood, a program for those in need to self-subscribe to receive daily supportive text messages. The program has shown clinical effectiveness in two randomized pilot trials.
What problem or opportunity did you identify and seek to address?
Moving to Fort McMurray from Dublin in 2013, I realized there were two main problems facing somebody in distress seeking access to mental health services and counselling opportunities. First, it could take upwards of 13 weeks to access psychological counselling services. Then, the geographic barriers made it difficult to access these services when available.
Text4Mood is an online program that allows for the delivery of daily supportive text messages to patients with depression, anxiety, and other psychological issues. It allows for thousands of messages to be sent out simultaneously to those who self-subscribe to the program.
Addiction and mental health counsellors as well as patients have developed the messages based on Cognitive Behavioural Therapy (CBT) principles. It’s quite similar to the messages that you’d get from an addiction or mental health counsellor in face-to-face counselling.
We conducted two randomized control trials of the program in patients with depression prior to launching the program. The trials indicated that although the messages are not individualized, they are actually very effective in reducing depression symptoms compared to a similar patient population who did not receive messages.
What has been the impact?
If you sign up today, you begin to receive the messages tomorrow. As a result of the Text4Mood program, the wait time to receive messages or psychological counselling is reduced from 13 weeks to just 24 hours. Since Text4Mood launched, we have had over 20,000 Albertans self-subscribe to the program.
On top of the success of the Text4Mood program, we have gone on to launch the Text4Support program in the Edmonton Zone, which we are hoping to replicate across the province.
The Text4Support program targets specific patients who are accessing addiction and mental health programs from Alberta Health Services (AHS). They do not need to self-subscribe but are rather inputted into the system.
The other feature of the Text4Support program is that we have the messages grouped into various banks, so we have messages specifically targeting depression, anxiety, psychosis, bipolar disorder, alcohol addiction and general messages for crisis situations. Patients are able to choose the bank of messages they want to receive depending on the acquiescing problems.
How has being in Alberta helped you find success?
If I were not in Alberta, this would have remained a vision, which probably would never have been realized. In 2014, the initial funding came from the AHS Quality Improvement grant. AHS addiction and mental health therapists as well as patients attending Fort McMurray mental health services drafted all the text messages.
The two randomized trials conducted prior to the launch of the program where in Fort McMurray and Grand Prairie and the staff of the Northern Lights addiction facility in Grand Prairie served as research assistants and coordinators to recruit patients for the trial. This project took the contributions from a whole range of AHS employees and patients within Alberta as well as my colleague physicians and research colleagues in the Department of Psychiatry at the University of Alberta.
Who have been your major supporters?
When we launched the Text4Mood program, we were expecting 500 people to enrol. Within six weeks we had over 4,000 people enrol and that created a problem for us because we quickly ran out of text messages. AHS stepped up to the plate and provided funding.
During the 2016 Fort McMurray wildfire, the program was very helpful in disseminating information to victims. The Fort McMurray Red Cross recovery fund provided funding which has sustained the program to this day and AHS continues to explore ways of supporting the program into the future.
What are the plans for the future?
Text4Support is certainly one development that we are pursuing. We also see an opportunity to use the supportive text messages to help victims of natural disasters. We have also discussed with First Nation communities in British Columbia about the possibility of using supportive text messages to increase the level of psychological support from those who are victims of wildfires and flooding.
We are also thinking about the possibility of promoting reminder text messages for addiction and mental health patients accessing community programs. It’s typical for about 30% of patients to miss or cancel their outpatient appointments. This represents significant inefficiencies and a huge financial loss to AHS. If we are able to use reminder text messages to even halve the number of no-shows or cancellations for outpatient appointments, that’ll be a significant gain in terms of efficiencies and improvement in the quality of life of the patients we serve.
How does it feel to be an ASTech Finalist?
I think it is great! There has not been a Finalist within the department of Psychiatry for several decades. It’s not just exciting for myself; it is exciting for the whole department of Psychiatry at the University of Alberta. I am also hoping this will be a winning award for the patients who the program was developed for.
I’m certainly very excited to be one of the Finalists. I think it speaks to the fact that in Alberta, if you put in the energy and the effort into trying to develop new things that will benefit the population, then you can expect to be recognized for your contribution. It certainly is going to spur me on to do more for my patients.