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Alberta’s Text4Hope campaign successful in reducing stress, anxiety amid COVID-19 pandemic: research

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The Text4Hope campaign launched last March. The free service sends daily text messages to subscribers to help them identify and adjust negative thoughts, feelings and behaviours brought on by the pandemic. File

A daily text service aimed at helping with stress, anxiety and depression during the COVID-19 pandemic has proven successful, according to new research.

The Text4Hope campaign launched last March. The free service service sends daily text messages to subscribers to help boost their mental health by focusing on identifying and adjusting negative thoughts, feelings and behaviours brought on by the pandemic.

The messages are meant to provide advice and encouragement to develop healthy personal coping skills, according to Alberta Health Services.

Read more: Coronavirus: New texting initiative gives Albertans mental health support

Since March, more than 50,000 people have subscribed to the daily text service.

Previously published research showed that when respondents signed up for the Text4Hope service, nearly 85 per cent reported moderate to high stress, almost 50 per cent were at risk for an anxiety disorder and more than 40 per cent were at risk for clinical depression.

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Researchers have since analyzed self-reported symptoms of stress, anxiety and depression from 1,079 participants surveyed at the outset, after six weeks and again after three months.

After six weeks, respondents reported reduced stress and anxiety.

After three months, “statistically significant improvements” were reported in all of the measures the researchers set out to evaluate. Mental health distress dropped by 22.7 per cent for anxiety, 10.4 per cent for depression and 5.7 per cent for stress.

“All the numbers seem to be moving on a downward trajectory,” said Vincent Agyapong, clinical professor of psychiatry and global mental health in the University of Alberta’s Faculty of Medicine & Dentistry.

Agyapong created the text service.

“Put that in the context that the pandemic is still on, the stress is still here, people’s jobs have not returned,” he said. “We can see that in a real-world situation, this is actually working and making a clinically meaningful impact in people’s lives.”

Read more: ‘Anxiety and depression are increasing’: Alberta doctor sees spike in mental health visits

The daily text messages — which include things like “You are not alone” and “Practise self-compassion” — follow the same principle as cognitive behavioural therapy because they disrupt negative thinking patterns, Agyapong said.

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“You may be thinking constantly about job loss, the COVID case numbers going up, the future of the economy, the end of air travel,” he said. “Then a message will come up that reminds you there’s only one day you need to worry about and that’s today. The past is gone and the future will take care of itself.

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“A daily dose of positivity coming into your life will help you dwell less on the worry and anxiety.”

Another study is planned, which would compare symptoms such as suicidal ideation and interrupted sleep patterns among a smaller group of subscribers against a control group that did not receive the texts.

Click to play video 'Increase in mental health calls to distress line during pandemic' Increase in mental health calls to distress line during pandemic
Increase in mental health calls to distress line during pandemic – Jan 17, 2021

A clinical trial is also underway, comparing the effectiveness of texts versus email. Agyapong said this would be capable of reaching more people around the world.

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“If we can reduce the number of people who need that one-to-one therapy, then we can provide more timely and comprehensive care for those who actually need it,” he said.

Read more: Petition calls for government to fund psychologist visits for all Albertans

Work is underway to develop an Arabic language version of the Text4Hope project. A version of the program for Indigenous communities in British Columbia will also be piloted, as well as tailoring a service to target first responders and military veterans with post-traumatic stress disorder. A youth-focused version will also be launched.

Agyapong noted that participation in the service and the surveys was voluntary, so the results may not be representative of the overall population. However, he noted the results are comparable to previous randomized controlled trials of similar text message services.

Text COVID19HOPE to 393939 to subscribe to Text4Hope.

Where to get help

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide PreventionDepression Hurts and Kids Help Phone 1-800-668-6868  all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

The Mental Health Helpline

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  • Provides confidential, anonymous service, including crisis intervention, information on mental health programs, and referrals to other agencies if needed.
  • The Mental Health Helpline is available at 1-877-303-2642.

Alberta Health Services’ Help in Tough Times

  • Provides links to supports and services, including addiction and mental health, available to Albertans.

Togetherall

  • Clinically moderated, online peer-to-peer mental health community that empowers individuals to anonymously seek and provide support 24/7.
  • Togetherall is free to all Albertans aged 16+.

AHS’ virtual addiction and mental health services

  • Services and supports free to Albertans.

Alberta 211

  • Provides information, including support via phone, text, chat and website referrals and resources addiction and mental health referrals and resources.
  • Professionally trained specialists are available by texting INFO to 211, live chat through the website, ab.211.ca or calling 2-1-1.

The Crisis Services Canada Suicide Prevention Service

  • Offers a 24/7 helpline for people thinking about or affected by suicide via phone, text or chat (1-833-456-4566).

Kids Help Phone (expanded) 

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  • Provides free, confidential 24/7 services for children, youth, and young adults.
  • Services include professional counselling by phone, and volunteer-led information and crisis support via phone, text, or chat.

Wellness Together Canada

  • Provides free online resources, tools, apps and connections to trained volunteers and qualified mental health professionals when needed.

The Crisis Text Line Alberta

  • Available 24-7
  • Offers information, referrals and volunteer-led, text based support for Albertans of all ages, by texting CONNECT to 741741.