A new study finds that a mobile phone intervention, commonly referred to as mHealth, may be as effective as a clinic-based group intervention for people with serious mental illness.
For the study, researchers compared the mHealth approach (FOCUS) to a more traditional clinic-based group intervention, the Wellness Recovery Action Plan (WRAP). The research team, led by Dror Ben-Zeev, Ph.D. from the University of Washington, Seattle, analyzed the differences in treatment engagement, satisfaction, improvement in symptoms, recovery and quality of life.
The research involved 163 participants with long-term, serious mental illness, including schizophrenia, schizoaffective disorder, bipolar disorder and major depressive disorder. Participants were randomly assigned to either the smartphone-based FOCUS group or the clinic-based WRAP group.
The interventions lasted 12 weeks. Assessments were conducted pre-intervention, post-intervention, and at a six-month follow-up.
FOCUS is a smartphone-delivered intervention developed for people with serious mental illness. It has three main components: the FOCUS app, a clinician dashboard, and support from an mHealth specialist.
It includes daily self-assessment prompts and content that can be accessed 24 hours a day as either brief video or audio clips, or a series of written material with images. The patients’ responses to the daily self-assessments are sent to the support specialist, who holds weekly calls with each individual.
WRAP is a widely used group-based, self-management intervention led by trained facilitators with personal experience of mental illness. It emphasizes equipping oneself with personal wellness tools and focusing on recovery concepts, such as hope and self-advocacy.
On random assignment, participants in the mHealth group were more likely to begin mental health treatment (90 percent), compared with WRAP (58 percent). Significantly more FOCUS participants completed eight or more weeks of treatment, but the percentage completing the full 12 weeks was similar for the two groups.
Once the intervention was over, patients in both groups had improved significantly. WRAP participants showed significant improvements in recovery at the end of treatment (three months), and mHealth participants showed significant improvement in recovery and quality of life at six months.
Participants in both groups reported high satisfaction, noting the interventions were enjoyable and interactive and helped them feel better. Age, gender, race, having prior experience with smartphones, and number of previous psychiatric hospitalizations were not tied to recovery outcomes.
The study is the first randomized controlled trial comparing a smartphone intervention to a clinic-based intervention involving individuals with schizophrenia spectrum disorders.
The findings are published in the journal Psychiatric Services.
Source: American Psychiatric Association