Digital health innovation to prevent relapse and support recovery in young people with first-episode psychosis: A pilot study of Horyzons-Canada

Shalini Lal; John F Gleeson; Simon D'Alfonso; Hajin Lee; Geraldine Etienne; Ridha Joober; Martin Lepage; Mario Alvarez-Jimenez

doi:10.1038/s41537-023-00352-1

Digital health innovation to prevent relapse and support recovery in young people with first-episode psychosis: A pilot study of Horyzons-Canada

Schizophrenia (Heidelb). 2023 Apr 7;9(1):21. doi: 10.1038/s41537-023-00352-1.

Authors

Shalini Lal^{1

2

3}, John F Gleeson⁴, Simon D'Alfonso⁵, Hajin Lee^{6

7}, Geraldine Etienne⁸, Ridha Joober^{8

9}, Martin Lepage^{8

9}, Mario Alvarez-Jimenez^{10

11}

Affiliations

¹ School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada. shalini.lal@umontreal.ca.
² Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada. shalini.lal@umontreal.ca.
³ Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montréal, QC, Canada. shalini.lal@umontreal.ca.
⁴ Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia.
⁵ School of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia.
⁶ School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
⁷ Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.
⁸ Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montréal, QC, Canada.
⁹ Department of Psychiatry, McGill University, Montréal, QC, Canada.
¹⁰ Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
¹¹ Orygen, Parkville, VIC, Australia.

Abstract

Digital health innovations may help to improve access to psychosocial therapy and peer support; however, the existence of evidence-based digital health interventions for individuals recovering from a first-episode psychosis (FEP) remains limited. This study aims to investigate the feasibility, acceptability, safety, and pre-post outcomes of Horyzons-Canada (HoryzonsCa), a Canadian adaptation of a digital mental health intervention consisting of psychosocial interventions, online social networking, and clinical and peer support moderation. Using a convergent mixed-methods research design, we recruited participants from a specialized early intervention clinic for FEP in Montreal, Canada. Twenty-three participants (mean age = 26.8) completed baseline assessments, and 20 completed follow-up assessments after 8 weeks of intervention access. Most participants provided positive feedback on general experience (85%, 17/20) and the utility of Horyzons for identifying their strengths (70%, 14/20). Almost all perceived the platform as easy to use (95%, 19/20) and felt safe using it (90%, 18/20). There were no adverse events related to the intervention. Participants used HoryzonsCa to learn about their illness and how to get better (65%, 13/20), receive support (60%, 12/20), and access social networking (35%, 7/20) and peer support (30%, 6/20). Regarding adoption, 65% (13/20) logged in at least 4 times over 8 weeks. There was a nonsignificant increase in social functioning and no deterioration on the Clinical Global Impression Scale. Overall, HoryzonsCa was feasible to implement and perceived as safe and acceptable. More research is needed with larger sample sizes and using in-depth qualitative methods to better understand the implementation and impact of HoryzonsCa.