Does SMS improve gambling outcomes over and above access to other e-mental health supports? A feasibility study

SMS is simple, inexpensive and a convenient method of delivering interventions to people with problem gambling, but there are currently no trials investigating its feasibility or impact. This study explores the feasibility of SMS for people with problem gambling accessing an e-mental health service (i.e. chat, email, forums and brief self-help). The study randomized 198 gamblers to bi-weekly SMS (versus treatment-as-usual [TAU]) over a 12-week period. SMS involved a series of behaviour change techniques as well as a call-back for further help. Recruitment and randomization workflow, SMS implementation and the impact of text messages on engagement at 12-week follow-up evaluation were also examined. Four out of five gamblers accessing e-mental health were willing to take part and very few withdrew from the study. Furthermore, 10% accessed the new outbound service (text for immediate HELP). There was a significant decrease in gambling symptoms and time and money spent post-treatment, but there was not a significant difference between SMS and TAU (i.e. SMS did not increase the effect of e-mental health). Gamblers accessed an average of 2.5 e-mental health offerings at their initial visit and it could be that this mixture of service supports more than met current needs.