Because SMS is such an accessible and comfortable means of communication and outreach, it has seen great success in a number of programs and pilots intended to offer mental health support. A notable example is an SMS intervention program for depression among low-income communities that was piloted in California. Participants received text message reminders to take any medications they are prescribed, as well as to do cognitive-behavioral and self-awareness work such as reflecting on positive experiences and interactions and logging their moods. Many participants found the program helpful, and 75% wanted to continue receiving the texts when the program concluded.

Text messaging has also been a powerful support network for many teens struggling with mental illness or poor mental health. Several SMS programs have been put into effect to connect young people to mental health resources as well as to provide immediate support. Programs like DoSomething's text line or Crisis Text Line offer anonymous, non-judgmental listening via text, and very often hear from teens in the heat of an episode that they help deescalate. Such programs can also work to text teens experiencing poor mental health about relevant resources they may benefit from. 

Such programs are especially effective because they take advantage of a familiar medium to young people, one that most teens are very comfortable using. They are also quiet and anonymous. DoSomething's text line incurs no fees on either end, so the service doesn't appear on any phone bills, and doesn't save user information except for the phone number used.

Text messaging has been applied to even more specific mental health situations. Notably, a Saint Louis University paper from 2015 indicates that text messaging programs can be an effective way of addressing post-partum depression, often a crippling if not dangerous syndrome. New mothers without strong financial and familial support systems who scored high on a post-partum depression screening received four texts each week for six months. Each text offered practical information, motivational messages, or an opportunity to check-in and have a conversation about how they are doing. Most participants found the texts convenient and personally relevant, and 75% even shared the texts with others.

Some therapists may also use SMS in varying capacities to communicate with their patients. Text messaging can be a quick and convenient means not only to coordinate logistics but for patients to reach out and seek help in moments when they urgently need it. However, therapists might end up in a tricky position regarding boundaries with their patients; if patients text their therapists too frequently, they may rely too much on direct contact with their providers rather than applying what they learn in therapy and developing autonomy and other valuable skills. In such a situation, therapists may also simply not be able to keep up with the volume and demand of the text messages. And should a therapist have to "cut off" a patient on SMS abruptly, the patient may find themselves in a very challenging position.

A failed text-messaging system between therapist and patient may not be the only downside texting can pose for mental health. For developing teens, texting in high volumes can cause attentional deficits that can have a range of negative consequences for the adolescent. The average teenager sends and receives a total of about 50 texts per day, with one in three teens sending and receiving 100 or more each day, and one in seven sending more than 200 texts each day. Attending to one's phone at so many vibrations throughout the day, and often multitasking in order to reply, can instill a poor attention span and poor focus in young people.

The ability to concentrate is not only important to academic and work performance, which themselves can affect one's mental health, but a teen's ability to meditate on and engage with their thoughts and mental states. Additionally, poor attention can amplify existing symptoms of anxiety and depression, which often entail difficulty focusing. Texting so frequently may also pull teens away from meaningful face-to-face time with family and friends, which can be important to good mental health or valuable support for mental illness. 

Texting also seems to be keeping teens up at night. Teens feel compelled to respond to text messages past bedtime, or are sucked in by the convenience of using their phones in bed, often losing sleep because of text message conversations and other activities on their mobile phones. A healthy amount of sleep is especially important for adolescents, who can suffer mental and physical health issues when their sleep is compromised. Teenagers who get less than the recommended amount of sleep are at a much higher risk for mental illness.

Like most things with which we have an expansive and complicated relationship, texting has many ups and downs. While the potential it holds for bolstering mental health, especially among young people, is great, it may also be doing damage. It seems that the key is having a balanced relationship with our devices, where we can engage with the resources in our environments, but our phones are always there when we need them.

About the Author -
Sharon Housley is the VP of Marketing for NotePage, Inc. a software company for communication software solutions. http://www.notepage.net