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

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.