JMIR Mental Health · Published 2026-02-23 · DOI 10.2196/93954
Abstract BackgroundPsychiatric hospitalizations are a major driver of mental health–related health care costs, with readmission risk and service utilization being highest in the months following discharge. Scalable, low-cost postdischarge interventions that reduce inpatient utilization are therefore of high policy relevance. ObjectiveThis secondary exploratory economic study used linked administrative health care utilization data to evaluate the economic impact of supportive text messaging (SMS), alone and in combination with peer support services (PSS), following discharge from acute psychiatric care. MethodsThis secondary exploratory economic evaluation was conducted alongside a pragmatic stepped-wedge cluster randomized trial in Alberta, Canada. Adults discharged from acute psychiatric inpatient care received treatment as usual (TAU), SMS, or SMS with or without PSS. Direct health system costs, including hospital care and physician costs, were assessed using administrative data for 6 months and 12 months before and after the index admission. Difference-in-difference analyses were used to estimate cost changes between groups. ResultsAt 6 months post discharge, the period of greatest new costs, participants receiving SMS experienced a significant reduction in hospital care costs compared with TAU (mean difference-in-differences −$7147; 95% CI −$12,388 to −$1906; P ConclusionsSMS was associated with significant reductions in hospital care and total health care utilization costs during the 6-month postdischarge period compared with TAU. These findings support the integration of cost-effective and scalable digital interventions into routine psychiatric discharge pathways to help improve system efficiency in publicly funded health systems.
Abstract from DOAJ. Public domain (CC0 1.0).
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