ED to EPI: Using SMS to Improve the Transition From the Emergency Department to Early Psychosis Intervention

Summary

Psychosis is a disabling condition that typically has its onset in adolescence and early adulthood. Many young people with psychosis have difficulty navigating services or are reluctant to engage in treatment until their illness becomes an emergency. Consequently, nearly half of all new psychotic disorders are diagnosed in the emergency department (ED). Despite the rationale and evidence for early psychosis intervention (EPI), around half of youth do not access these services. The investigators will use short message service (SMS)/text messaging, a low-cost, low-complexity, youth-friendly approach, to improve transitions in care from the ED and related acute services to EPI services, investigating the intervention's effect on attendance at the first consultation appointment, longer term service engagement, and system-level outcomes. The investigators will also evaluate cost-effectiveness and user perspectives of the intervention.

Conditions

• First Episode Psychosis
• Psychosis
• Psychotic Episode
• Psychoses, Affective
• Bipolar Disorder
• Depressive Psychosis
• Schizoaffective Disorder
• Schizophreniform Disorders
• Schizophrenia
• Schizophrenia Spectrum and Other Psychotic Disorders
• Substance Induced Psychoses

Interventions

BEHAVIORAL

Active SMS Intervention

Welcome message letting participant know they will be contacted to book an appointment, followed by appointment reminders and other clinic information, psychoeducational materials, and a distress check-in with two-way feedback to their care team, all sent by SMS/text message at the participant's preferred time of day. If they indicate that they are in high distress, or they request, their care provider will be notified and asked to reach out to them. They will also receive crisis resources.The intervention will continue until the patient attends the first consultation appointment, or for up to 30 days if the patient does not attend, which reflects the program's practice of closing referrals for non-attending patients.

BEHAVIORAL

Sham SMS

Single welcome message letting participant know they will be contacted to book an appointment.

Sponsors & Collaborators

• Canadian Institutes of Health Research (CIHR)

  collaborator OTHER_GOV

• Institute for Clinical Evaluative Sciences

  collaborator OTHER

• Centre for Addiction and Mental Health

  lead OTHER

Principal Investigators

• Nicole Kozloff, MD, SM · Centre for Addiction and Mental Health

• George Foussias, MD, PhD · Centre for Addiction and Mental Health

• Aristotle N Voineskos, MD, PhD · Centre for Addiction and Mental Health

• Vicky Stergiopoulos, MD, MHSc · Centre for Addiction and Mental Health

• Albert HC Wong, MD, PhD · Centre for Addiction and Mental Health

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

16 Years

Max Age

29 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-09-21

Primary Completion

2025-06-20

Completion

2025-12-20

Countries

• Canada

Study Locations