BACKGROUND The past few decades have seen an exponential increase in using mobile phones to support medical care (“mHealth”) among people living with psychosis worldwide, yet little is known about WeChat use and WeChat-based mHealth among people living with schizophrenia (PLS) in China. OBJECTIVE The present study aims to assess WeChat use, endorsement of WeChat-based mHealth programs, and health related to WeChat use among PLS. METHODS We recruited a random sample of 400 PLS from 12 communities were recruited in Changsha City of Hunan Province, China. WeChat use was assessed using the adapted WeChat Use Intensity Questionnaire (WUIQ). We also measured psychiatric symptoms, functioning, disability, recovery, quality of life, and general wellbeing using a series of internationally standardized instruments. RESULTS WeChat use rate was 41% in this sample (163/400). Thirty percent had more than 50 WeChat friends and nearly half spent more than half an hour on WeChat, a pattern similar to college students and the elderly. PLS also showed higher emotional connectedness to WeChat use than college students. Eighty percent of PLS were willing to participate in a WeChat-based mHealth program, including psychoeducation (56%), professional support (50%), and peer support (41%). Compared to non-users, WeChat users were younger, better-educated, and more likely to be employed. WeChat use was associated with improved health outcomes, including lower psychiatric symptoms, lower disability, higher functioning, better recovery, higher quality of life, and better general well-being. CONCLUSIONS WeChat-based mHealth programs hold promise as an empowering tool to provide cost-effective interventions, to foster global recovery, and to improve both physical and mental wellbeing among people with schizophrenia. WeChat and WeChat-based mHealth programs has the potential to offer a new path to recovery and wellbeing for people living with schizophrenia in China. CLINICALTRIAL NA

Schizophrenia is a persistent and debilitating mental illness, whose prognosis depends largely on supportive care and systematic treatment. In developing countries like China, family constitute the major caregiving force for schizophrenia and are faced with many challenges, such as lack of knowledge, skills and resources. How to support family caregiving in an accessible, affordable, feasible and cost-effective way remains unresolved. The widely spread use of WeChat provides a promising and cost-effective medium for support.