Grant: Team Grant: TiC - Stream 1 - PHSI solutions for transitions in care gaps

Psychosis, a syndrome characterized by loss of touch with reality, is a disabling and life-threatening condition that typically starts in adolescence and young adulthood, a time of life associated with gaps in mental health service use. Despite the availability of effective treatment through early psychosis intervention (EPI) programs, around half of youth do not access these services. Even when youth with psychosis present in crisis to the emergency department (ED), rates of follow-up care are poor, in large part related to young people not attending EPI services when they are referred. The goal of this study is to improve transitions from the ED to evidence-based EPI services for youth with psychosis using a short message service (SMS) text messaging intervention. We will recruit 186 youth aged 16-29 referred by the ED for consultation in EPI services for a pragmatic randomized-controlled trial of 2-way SMS reminders, psychoeducation and check-ins, with the aim of improving rate of attendance at the consultation appointment. We will review participants' charts and link with provincial health data from the Institute for Clinical Evaluative Sciences to examine additional and longer-term indicators of service engagement and the effect of health equity factors such as gender and race/ethnicity. We will also perform cost-effectiveness analysis of the intervention and use qualitative methods to explore young people's perspectives on the intervention. The project will engage patient and family representatives, early career researchers and trainees, as well as key team members to champion spread of the intervention to other EPI programs and youth mental health services. Establishing evidence that a low-cost, easily implemented strategy improves transitions from the ED to EPI programs can result in more young people with psychosis getting appropriate treatment earlier, leading to improved long-term trajectories.