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Cell phone-based support programs

Health Factors: Family & Social Support
Decision Makers: Healthcare Professionals & Advocates Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 50-99% of WI's population
Impact on Disparities: No impact on disparities likely

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Cell phones, particularly smartphones, offer new opportunities to reach individuals in crisis and individuals with mental health concerns. Mobile phone applications (apps) can deliver a form of cognitive behavior therapy, link a user with a medical professional, or allow patients to regularly self-monitor their emotional state and easily share that information with a provider. Texting interventions range from crisis hotlines and warmlines that offer as needed and emergency support via text, to automated messages sent to individuals participating in longer term mental health interventions.

Expected Beneficial Outcomes

Improved mental health

Evidence of Effectiveness

There is some evidence that cell phone-based support programs reduce depression, anxiety, and stress (Donker 2013). Additional evidence is needed to confirm effects and determine which interventions are most effective.

Several mental health mobile applications (apps) appear to improve mental health (Donker 2013). A mobile stress management app, for example, has been shown to decrease anxiety and increase coping skills for oncology nurses and female university students; this app is publicly available in Italian (Donker 2013). An emotion monitoring app may increase emotional self-awareness among adolescents (Reid 2011), indirectly reducing depression over time (Kauer 2012). An effective computer-based cognitive behavioral therapy program for depression appears to remain effective when converted to app format (Watts 2013).

However, research assessing effects of text message-based mental health interventions is limited. Surveys of adolescents and adults suggest that such interventions are acceptable to patients, as long as security and privacy considerations are addressed (Ranney 2014, Proudfoot 2010). A small pilot of a text message program for patients with alcohol use disorder and comorbid depression indicates that messages may help to improve mental health and provide motivation to remain sober (Agyapong 2013).


United States

The number of services providing crisis intervention via text message is increasing across the country. Nevada’s Crisis Call Center was the first in the nation to provide text message crisis intervention services 24 hours a day (Crisis Call Center).  California’s Suicide Prevention Initiative includes creation and expansion of web and text-based crisis hotlines and warmlines (RAND-Burnam 2014). Crisis Text Line provides support to teenagers across the country (Crisis Text Line).

Implementation Resources

Crisis Call Center - Crisis Call Center. 24-hour crisis hotline. Accessed on January 28, 2016
Crisis Text Line - Crisis Text Line. Support for teens, 24/7. Accessed on January 28, 2016

Citations - Evidence

Agyapong 2013 - Agyapong VIO, Milnes J, McLoughlin DM, Farren CK. Perception of patients with alcohol use disorder and comorbid depression about the usefulness of supportive text messages. Technology and Health Care. 2013;21(1):31-9. Accessed on February 2, 2016
Donker 2013 - Donker T, Petrie K, Proudfoot J, et al. Smartphones for smarter delivery of mental health programs. Journal of Medical Internet Research. 2013;15(11):e247. Accessed on February 1, 2016
Kauer 2012 - Kauer SD, Reid SC, Crooke AHD, et al. Self-monitoring using mobile phones in the early stages of adolescent depression: Randomized controlled trial. Journal of Medical Internet Research. 2012;14(3):e67. Accessed on January 28, 2016
Proudfoot 2010 - Proudfoot J, Parker G, Pavlovic DH, et al. Community attitudes to the appropriation of mobile phones for monitoring and managing depression, anxiety, and stress. Journal of Medical Internet Research. 2010;12(5):e64. Accessed on January 28, 2016
Ranney 2014* - Ranney ML, Choo EK, Cunningham RM, et al. Acceptability, language, and structure of text message-based behavioral interventions for high-risk adolescent females: A qualitative study. Journal of Adolescent Health. 2014;55(1):33–40. Accessed on January 28, 2016
Reid 2011 - Reid SC, Kauer SD, Hearps SJC, et al. A mobile phone application for the assessment and management of youth mental health problems in primary care: A randomised controlled trial. BMC Family Practice. 2011;12(1):131. Accessed on January 27, 2016
Watts 2013* - Watts S, Mackenzie A, Thomas C, et al. CBT for depression: a pilot RCT comparing mobile phone vs. computer. BMC Psychiatry. 2013;13(1):49. Accessed on January 28, 2016

Citations - Implementation

Crisis Call Center - Crisis Call Center. 24-hour crisis hotline. Accessed on January 28, 2016
Crisis Text Line - Crisis Text Line. Support for teens, 24/7. Accessed on January 28, 2016
RAND-Burnam 2014 - Burnam MA, Berry SH, Cerully JL, Eberhart N, eds. Evaluation of the California mental health services authority's prevention and early intervention initiatives. Santa Monica: RAND Corporation; 2014: Research Report 438. Accessed on February 2, 2016

Page Last Updated

September 15, 2014

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