Texting for Relapse Prevention

Schizophrenia is among the 20 most debilitating illnesses worldwide, responsible for 1% of
the global burden of disease. Schizoaffective disorder (SAD) affects an additional 0.2% to
1.1% of adults. As many as four out of five people who have schizophrenia or SAD relapse
within 5 years of recovery from their initial episode. Interventions aimed at early
intervention to prevent relapse would impact public health.

The Texting for Relapse Prevention (T4RP) is an innovative service delivery program delivered
via text messaging designed for people who have schizophrenia/SAD. The intervention will be
tested in a randomized controlled trial against a treatment-as-usual control group which, for
most, involved meeting with their therapist every 2 to 4 weeks and meeting with their
psychiatrist at least once every 90 days or more frequently as clinically indicated. A total
of 40 people with schizophrenia and 5-15 provider participants (depending on the patient
distribution across the providers) in the pilot RTC. The study is being conducted by
researchers at the Center for Innovative Public Health Research and Johns Hopkins Community
Psychiatry Program (JHCPP).

The investigators posit that T4RP will reduce psychiatric morbidity and institutionalization
rates and promote recovery by facilitating improved patient-provider communication, promoting
medication adherence, helping people self-monitor their early warning signs, and promoting
self-management of symptoms.

If T4RP is effective, this cost-effective and easily scalable intervention will make a
significant public health impact and reduction in relapse-related costs for people with
schizophrenia/SAD.

Inclusion Criteria:

- be English-speaking;

- have a chart diagnosis of schizophrenia or SAD

- be able to provide consent (i.e., pass the Capacity to Consent screen)

- own a cell phone and report using the text messaging function

- be currently at their personal baseline with regard to symptoms and functioning as
assessed by their provider (i.e., not in relapse and compliant with treatment)

- be actively under the care of a mental health provider enrolled in the program

- agree to continue attending the clinic for the duration of the study

- plan to keep the same cell phone number for the duration of the study

- have at least one of their providers consent to take part in the study

Exclusion Criteria:

- have at least one of their providers consent to take part in the study