SMS4 perinatal parents: designing parenting support via text messages for mothers with severe mental illness (SMI) and their partners

Abstract

ABSTRACTObjective: This paper will describe the development of a programme of SMS messages including parenting information and support to be sent to the mobile phones of mothers with severe mental illness (SMI) and their partners from early pregnancy to 24 weeks post birth. Method: Text messages (total 176) designed and tested for fathers (SMS4Dads) addressing father-infant attachment, co-parenting and self-care (including Mood Tracker texts asking fathers to rate their mood) were adapted by an expert advisory group of clinicians with experience across perinatal mental health services. Messages were rated on importance, clarity, acceptability (separately for mothers and fathers) and being consistent with current evidence. Additional messages were developed specifically for this population and all messages were tested for literacy level. The SMS4dads ‘Mood Tracker’ was redesigned to address common stress-inducing parenting issues such as infant crying, lack of sleep, and self-doubt about capacity to parent with an escalation process in cases of significant distress. Results: Separate protocol tested text-message banks for mothers (141 messages), and fathers (141 messages) were developed. Fourteen Mood Tracker topics were developed with two levels of distress escalation linked to local mental health services. Discussion: The need for accurate descriptions of health interventions processes is widely recognised, particularly in the case of digital mental health. This study provides a detailed description of the adaptive design by clinicians and researchers of brief text messages suitable for mothers with severe mental illness and their partners.