Improving safety and access to care via a co-designed monitoring app

Severe mental illnesses (SMIs), including schizophrenia and other psychotic conditions, affect 24 million people worldwide, usually causing lifelong disability.

Relapse is common and often leads to repeated hospital admissions. Mobile symptom monitoring offers the potential for health professionals to identify early signs of relapse and act quickly to help prevent relapse and hospital admission. Our research has led to developing, testing, and deploying a smartphone app for people with SMIs.

We developed ClinTouch, a platform technology symptom-monitoring app that monitors mood and psychotic symptoms, which have been validated against gold-standard mood/symptom measures.

Academic researchers and software engineers worked together to develop and refine the app, ensuring that the system would reflect and respond to lived experience.

While testing it at 12 weeks, 90% of testers continued to use the system with a high level of completion of the questions related to symptoms within the app. App use was linked with the improvement of symptoms in participants who had been recently diagnosed. 

In addition to the standard symptom measures, the ClinTouch device provided additional real-time individual symptom data, and all symptoms declined in severity except one. Alerts for personalised early warning signs of relapse were built into clinical management systems and all staff members used the system.

The ClinTouch technology has provided a platform for developing other digital mental health apps including:

• Actissist – delivers cognitive-behaviour therapy self-management strategies for patients with early psychosis;
• ExPRESS – a symptom monitoring app for schizophrenia, which refines our predictive algorithm of psychosis relapse;
• EMPOWER system – an early signs monitoring app designed to prevent relapse in psychosis and promote wellbeing, engagement and recovery.

Relevant publications

• The feasibility and validity of ambulatory self-report of psychotic symptoms using a smartphone software application.
• Smartphone-enhanced symptom management in psychosis: open, randomized controlled trial.
• Actissist: proof-of-concept trial of a theory-driven digital intervention for psychosis.