247062 Assessing the Evidence of Self-Management in Clients with Serious Mental Illness

Monday, October 31, 2011

Aparna Kumar, BSN, RN, MA, MPH , Silverstein 9 Department of Neurology and Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA
Self-management, in its various definitions, is often supported as a part of the recovery model for clients with serious mental illness, particularly in the community setting. This paper seeks to assess current evidence surrounding self-management programs for the seriously mentally ill (SMI) in order to determine whether essential components of such programs exist as well as their standard outcome measures. A literature review of 10 studies was conducted and analyzed in terms of indicators, outcomes, and potential for future research related to self-management in adults with SMI. Peer supported programs, individualized plans, collaboration in decision making, improvement of self-efficacy, and targeted interventions do make a difference in terms of planning care for SMI clients as evidenced by the Illness Management and Recovery Model (IMRM) and the Shared Decision Model (SDM). Outcome indicators were not uniform across studies. At the core of outcomes measurement are enhanced control, capability to self-manage, and self-efficacy. The IMRM supports anxiety and psychosocial function as outcome indicators while the Wellness Recovery Action Plan (WRAP) program promotes hope and recovery oriented principles as outcomes indicators. Few studies demonstrated detrimental effects associated with self-management interventions although several did not show significant results. To date, no gold standard exists in self-management programs for the SMI. Generic as well as specific interventions showed positive results in terms of physical and mental health outcomes. Future interventions can look towards holistic generic or specific interventions for guidance depending on the target population, the resources available to the population, and the intended benefits.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related nursing

Learning Objectives:
Learning Objectives 1. Discuss five considerations for community based programs that promote self-management for persons with serious mental illness (SMI). 2. Identify three essential components of community based self-management programs for persons with a serious mental illness (SMI). 3. Design a model program containing essential indicators and outcomes of a self-management program for persons with a serious mental illness. 4. Develop an individualized care plan including the self-management model for persons with a serious mental illness (SMI), one utilizing a group based approach and one utilizing an individual approach (SMI).

Keywords: Self-Management, Mental Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be present because I have been a research assistant for nursing outcomes research on psychiatric and mental health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.