Active Assistance for Psychological Therapy 2.0 (Actissist 2.0): Digital Intervention for Co-producing care in psychosis.

Severe mental health problems (SMI) such as schizophrenia affect 24 million people worldwide. Schizophrenia is a severe form of psychosis - a general term that describes a change in people's behaviour, thinking and feelings. Psychosis affects people's ability to socialise, work and carry out the tasks of daily life. It usually begins in early adulthood. First episode psychosis is the first time someone experiences these changes. Most people with psychosis have more than one episode of psychosis, so people are at risk of long-term problems. The time after a first episode of psychosis is critical for a person's long-term recovery. This makes the early phase of psychosis an important time for treatment. The longer the delay in treating psychosis, the worse the illness becomes. The delivery of efficient and timely talking treatments for psychosis is a serious challenge in the current NHS climate. Traditional ways of offering therapy through face-to-face appointments can effect how efficiently treatment can be offered. We need increased availability and new, timely ways of delivering therapy when it is needed. Smartphones are now affordable and popular and are one way we can successfully deliver treatment safely and at point-of-need. Grounded in psychological theory and principles, we have developed a Smartphone app called Actissist that people can access anywhere, at the time they need it. In our previous research, we showed that people with early psychosis completed the app swiftly in their daily life over 12 weeks. We also showed that people liked using the app and that it was safe to use. The study we propose for this application is the next step along the research pathway. We aim to improve and test the benefits of our digital intervention by giving it to 75 early psychosis patients. We will compare outcomes with 75 people who use a different app (called ClinTouch), which just monitors psychosis and mood symptoms but does not provide self-managed therapy. Which app people get will be determined by chance so that the treatment can be compared in similar groups of people. Based on our previous work, we hope that Actissist will improve symptoms and other important areas of people's lives. We hope to gain a better understanding of how we can use digital technology to help provide day-to-day care. Finally, we hope that the Actissist app will empower people to self-manage their symptoms and therapy. Our overarching goal is to transform community care for severe mental health conditions and to give individuals more choice about how they receive healthcare and interact with services. By doing this, we hope to reduce the number of episodes of psychosis people have or at least keep these to a minimum. We will do this by translating psychological ideas and strategies into a user-friendly digital intervention that will be delivered through a Smartphone, which most people own and enjoy using. By doing this, we hope that we can help people notice if they are becoming unwell at an earlier point than if they relied on attending a mental health service. We hope that this will improve people's daily lives and keep them out of hospital. This study will provide patients, services and commissioners with information about different ways people can receive healthcare. We would like to make helpful treatments more accessible and provide choice about how therapy is delivered. Our vision is to give people a greater sense of control over their mental health and wellbeing, support the speed and quality of recovery over and above drug treatments while sustaining functional outcomes, and to support self-management.