{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:04:44Z","timestamp":1774260284212,"version":"3.50.1"},"reference-count":78,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alberta Labour and Immigration Department, Government of Alberta"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Public safety personnel experience various mental health conditions due to their work\u2019s complex and demanding nature. There are barriers to seeking support and treatment; hence, providing innovative and cost-effective interventions can help improve mental health symptoms in public safety personnel. Objective: The study aimed to evaluate the impact of Text4PTSI on depression, anxiety, trauma, and stress-related symptoms, and the resilience of public safety personnel after six months of providing supportive text message intervention. Methods: Public safety personnel subscribed to Text4PTSI and received daily supportive and psychoeducational SMS text messages for six months. Participants were invited to complete standardized self-rated web-based questionnaires to assess depression, anxiety, posttraumatic stress disorder (PTSD), and resilience symptoms measured on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Brief Resilience Scale (BRS), respectively. The assessment of mental health conditions was conducted at baseline (enrolment) and six weeks, three months, and six months after enrollment. Results: One hundred and thirty-one subscribers participated in the Text4PTSI program, and eighteen completed both the baseline and any follow-up survey. A total of 31 participants completed the baseline survey and 107 total surveys were recorded at all follow-up time points. The baseline prevalence of psychological problems among public safety personnel were as follows: likely major depressive disorder (MDD) was 47.1%, likely generalized anxiety disorder (GAD) was 37.5%, low resilience was 22.2%, and likely PTSD was 13.3%. At six months post-intervention, the prevalence of likely MDD, likely GAD, and likely PTSD among respondents reduced; however, a statistically significant reduction was reported only for likely MDD (\u221235.3%, X2 (1) = 2.55, p = 0.03). There was no significant change in the prevalence of low resilience between baseline and post-intervention. There was a decrease in the mean scores on the PHQ-9, GAD-7, PCL-C, and the BRS from baseline to post-intervention by 25.8%, 24.7%, 9.5%, and 0.3%, respectively. However, the decrease was only statistically significant for the mean change in GAD-7 scores with a low effect size (t (15) = 2.73, p = 0.02). Conclusions: The results of this study suggest a significant reduction in the prevalence of likely MDD as well as the severity of anxiety symptoms from baseline to post-intervention for subscribers of the Text4PTSI program. Text4PTSI is a cost-effective, convenient, and easily scalable program that can augment other services for managing the mental health burdens of public safety personnel.<\/jats:p>","DOI":"10.3390\/ijerph20054215","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T05:20:50Z","timestamp":1677475250000},"page":"4215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Text4PTSI: A Promising Supportive Text Messaging Program to Mitigate Psychological Symptoms in Public Safety Personnel"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5325-8054","authenticated-orcid":false,"given":"Gloria","family":"Obuobi-Donkor","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-6398","authenticated-orcid":false,"given":"Reham","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8277-2570","authenticated-orcid":false,"given":"Ejemai","family":"Eboreime","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7633-6529","authenticated-orcid":false,"given":"Belinda","family":"Agyapong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7326-2592","authenticated-orcid":false,"given":"Natalie","family":"Phung","sequence":"additional","affiliation":[{"name":"Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scarlett","family":"Eyben","sequence":"additional","affiliation":[{"name":"Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-7708","authenticated-orcid":false,"given":"Kristopher","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB T5J 4S2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Hilario","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Health and Social Development, The University of British Columbia, Kelowna, BC V1V 1V7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6347-4620","authenticated-orcid":false,"given":"Raquel da Luz","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7713-4099","authenticated-orcid":false,"given":"Chelsea","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzette","family":"Br\u00e9mault-Phillips","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanbo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-900X","authenticated-orcid":false,"given":"Andrew J.","family":"Greenshaw","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2743-0372","authenticated-orcid":false,"given":"Vincent Israel Opoku","family":"Agyapong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada"},{"name":"Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"05028","DOI":"10.7189\/jogh.12.05028","article-title":"Prevalence of depression, anxiety, and stress among first responders for medical emergencies during COVID-19 pandemic: A meta-analysis","volume":"12","author":"Huang","year":"2022","journal-title":"J. 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