Translating innovation into impact: a national policy dialogue on scaling and integrating evidence-based supportive text messaging into Canada's mental health care systems.

Authors

Belinda Agyapong, Linda Liebenberg, Ejemai Eboreime, Andrew J Greenshaw, Vincent I O Agyapong

Published in

Frontiers in digital health. Volume 8. Pages 1830295. Epub Jul 27, 2026.

Abstract

Supportive text messaging interventions have demonstrated efficacy in reducing symptoms of depression, anxiety, and stress, yet their integration into Canadian mental health systems remains variable. This national policy dialogue examined governance, implementation, and equity considerations associated with scaling evidence-based supportive text messaging programs across provincial and territorial care systems.
A structured virtual policy dialogue convened senior representatives from provincial and territorial health authorities, federal agencies, community mental health organizations, crisis service providers, philanthropic foundations, and academic researchers. The session combined an evidence review with moderated deliberation, focusing on system integration, crisis pathway alignment, funding models, digital infrastructure, equity, and evaluation. The dialogue was transcribed verbatim and analyzed using an inductive-deductive thematic analysis. Interpretation of findings was informed by the Consolidated Framework for Implementation Research (CFIR), the Exploration, Preparation, Implementation and Sustainment (EPIS) framework, and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to examine implementation determinants, scalability, sustainability, and health system integration.
Stakeholders demonstrated broad consensus regarding the scalability, feasibility, and cost-effectiveness of supportive text messaging. High-priority integration points included post-emergency department discharge, post-psychiatric hospitalization follow-up, suicide prevention caring contact models, and stepped-care pathways. Participants emphasized the need to embed digital interventions within existing community mental health infrastructure rather than displacing in-person services. Equity considerations, including cellular connectivity limitations in the northern regions, linguistic diversity, and Indigenous co-creation, were central to implementation discussions. Fragmentation across jurisdictions and inconsistent evaluation frameworks were identified as barriers to coordinated scale-up. There was support for exploring pan-Canadian coordination mechanisms while preserving provincial autonomy.
Supportive text messaging represents a mature, evidence-based digital intervention with potential to enhance continuity of care and optimize system capacity. The primary barriers to broader integration appear structural rather than scientific. Coordinated implementation, sustained funding, culturally grounded co-design, and standardized evaluation frameworks will be essential to realizing its system-level impact within Canada's mental health care landscape.

PMID:
42577240
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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