Texting Support for Mental Health Care: A Scoping Review

Introduction: Mobile phone text messaging (Short Message Service; SMS) interventions are digital health strategies that may support mental health care. This scoping review examined related study designs, outcomes, and gaps across the literature. Methods: Systematic searches identified 38 eligible studies from 1542 abstracts. Data were extracted and thematically analyzed to identify trends and outcomes. Texting interventions were categorized as cognitive, motivational, instrumental/practical, or combined approaches. Results: Study design included randomized controlled trials (RCTs), quasi-experimental pilots and systematic reviews, with RCTs providing the strongest evidence for improvements in adherence and relapse prevention. Outcomes included behavioral measures (e.g., medication adherence, therapy homework completion, and reduced non-attendance) alongside clinical measures (e.g., symptom reduction and relapse prevention). Cognitive reminders that were most common reduced non-attendance and improved adherence, particularly for medication and appointments, although they were less effective in severe depression. Motivational and combined interventions demonstrated higher acceptability and engagement, particularly in adolescents and high-risk individuals. Success was influenced by diagnosis, age, gender, and social status, including adherence at baseline. Conclusions: Overall, text-based interventions were generally acceptable, accessible, and cost-effective for improving mental health engagement. Limitations included lack of long-term evaluations, technological barriers, and lack of personalization. Future research should address these gaps and include underrepresented populations.