Asynchronous Text-Based Mental Health Support: Real-World Evidence of Next Day Mood Improvement in Non-Clinical Population

Abstract

Introduction: Mental health applications are known to offer innovative means to support emotional wellbeing, providing users 
with resources like online or virtual therapy, mood tracking, and self-help strategies via their mobile device. Of these, asynchronous 
text-based interventions are known to be effective adjuncts to traditional or online (synchronous) therapy, leading to symptom 
reduction, effective engagement between sessions and adherence to medication among other positive effects. However, results on 
the effectiveness of asynchronous text-based interventions are mixed, with most studies focused on patients with diagnosed mental health conditions and often emphasize its use as an adjunct to traditional or online (synchronous) therapy. To our knowledge, no study has reported the effectiveness of asynchronous texting as a preventive tool (with an undiagnosed population) independent from other modes of therapeutic interventions. Using real world data, the present study examined the relationship between asynchronous text-based engagement with a mental health professional via the Thoughtful app and next-day mood improvements. 

Methods: Secondary data provided by Thoughtful World was extracted from the database which consist of 234 unique individuals 
who had spent at least 30 minutes of asynchronous texting with a mental health professional prior to the measurement of next-day 
mood. Mood scores that were recorded before the day of intervention was taken as baseline scores. Variables such as gender and age, mood scores (before and after using the asynchronous texting feature), time spent using the app were collected and analysed. All data were collected via the Thoughtful app and is based on a real world (non-controlled) setting. Permission for use of deidentified data was obtained from all participants prior to the overall wellbeing program as stated in the terms of use and informed consent. 

Results: The paired T-test indicated there was a significant increase in mood from before the session (M = 1, SD = 0) to after (M 
= 2.21, SD = 0.857), t(233) = -21.7, p < .001. The mean increase in the mood before and after the session is 1.21, with a 95% 
confidence interval ranging from - 1.66 to – 1.10. The eta squared statistic (.67) indicated a large effect size. 

Discussion & Conclusion: The observed improvement noted from these sessions reinforces the efficacy of -asynchronous text-based interventions in improving next-day mood. For undiagnosed individuals experiencing short term emotional distress, asynchronous texting with a mental health professional; is able to provide effective emotional support and mood regulation independent of its use with other forms of interventions. The findings from this research suggest that interventions of this nature could be effectively applied in broader populations beyond those diagnosed with mental health conditions to combat low mood levels and enhance overall psychological well-being. Moving forward, it is essential for future research to explore the underlying mechanisms that facilitate mood improvements and to examine additional variables that could influence these outcomes, such as frequency and intensity of the interventions. These insights will be instrumental for clinicians in developing comprehensive treatment plans that prioritise prevention as well as psychological and emotional well-being.