Evaluation of supported self-management smartphone app for psychosis

For adults recovering from psychosis, supported self-management has shown the potential to reduce psychological distress, promote recovery, improve adherence to medication and reduce the likelihood of future hospital admissions.

However, supported self-management strategies are only patchily used in NHS clinical settings, and there is a lack of well-evaluated tools to increase their use and effectiveness. More research is needed to identify promising approaches that are worth testing on a large scale.

This project aimed to address this evidence gap by testing the feasibility of a supported self-management app for adults using Early Intervention in Psychosis (EIP) services. 

The 'My Journey 3' app was the product of collaboration with adults with experience of psychosis and experts in digital mental health, and adapting existing paper-and-pen self-management tools. It aimed to help people with psychosis build their confidence, learn skills to take back control, and reduce the chance of future episodes.

Users can make plans for their recovery, keep track of their progress and any medication they are taking, and find jargon-free information about mental health and the services available. 

We aimed to find out whether the app was acceptable to service users and clinicians in an early psychosis service and whether a larger-scale effectiveness trial of this intervention is feasible and warranted. The eventual aim of the project is to increase the uptake of self-management approaches by adults with first-episode psychosis and improve recovery via the use of a smartphone app.

We recruited 40 users of Early Intervention in Psychosis (EIP) services to participate in the study over a one year period. 20 participants were randomly selected to receive the 'My Journey 3' app plus Treatment As Usual (TAU), while the other 20 participants received TAU only.

We collected anonymised usage data straight from the app, and also conducted qualitative interviews with service user participants and clinical staff that supported them with the app.

Engagement with the app varied between participants. On average, participants used the app 16.5 times during the study period, with the symptom tracker being the most frequently used.

For many service users support with 'My Journey 3 from clinicians was important for encouraging use, but was infrequent.

Retention for the study was high at with 83% and 75% of participants completing research assessments at 4 and 12 months.

The project demonstrated that it was feasible to recruit and retain participants from an early psychosis service, and that the 'My Journey 3' app can be delivered and effective in a trial setting. Therefore, a larger-scale effectiveness trial of this intervention is feasible and warranted.

This is particularly useful for clinicians working with people with first-episode psychosis, and researchers developing digital mental health interventions.

University College London

Camden and Islington NHS Foundation Trust