Peer and Text Message Support to Reduce Readmission Rates for Patients Discharged From Acute Psychiatric Care

Avoidable hospital readmissions are a pressing problem for our healthcare system. They lead to substantial human suffering and higher financial costs. Most discharged psychiatric inpatients in Alberta are offered follow-up appointments with Alberta Health Services (AHS) Addiction and Mental Health (AMH) community providers. Patients often wait 28-38 weeks for their first appointment, which leads many to miss their first appointments, and increases the likelihood of relapse. As a result, patients discharged into the community are readmitted to the Emergency Department (ED). To address this significant revolving door, the investigators will implement a low-cost, evidence-based system that delivers daily supportive texts to patients' mobile phones. The text messages developed by experts and service users, based on cognitive behavioral therapy principles. Our proposed program also includes peer support from previous mental health patients who have had similar challenges as participants, but are now in recovery. In this way, the investigators aim to reduce the psychological treatment and support gap for AMH patients who have been discharged from acute care and are scheduled to receive mental health and psychiatric treatment from A\&MH services after a long wait. Our pilot test of these interventions provide evidence that psychiatric readmissions, and emergency department visits can be reduced by 10-25% if implemented at scale in Alberta, thus resulting in cost-savings for individuals and the province.

Inclusion Criteria: * Patients who are 18 or 65 years of age * Able to provide informed written consent have been diagnosed with mental health condition, and are ready for discharge. * Patients should have a mobile device capable of receiving text messages Exclusion Criteria: * Patients will be ineligible if they do not meet the above inclusion criteria, * If they have an addiction disorder but not a mental health diagnosis * Are not capable of reading text messages from a mobile device or if they know they will be out of town during the 12-month follow-up period. * Patients are also ineligible if they do not consent to take part in the study,