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Self-management interventions for people with severe mental illness: systematic review and meta-analysis

  • Melanie Lean (a1), Miriam Fornells-Ambrojo (a2), Alyssa Milton (a3), Brynmor Lloyd-Evans (a4), Bronwyn Harrison-Stewart (a5), Amina Yesufu-Udechuku (a6), Tim Kendall (a7) and Sonia Johnson (a8)...

Abstract

Background

Self-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.

Aims

To evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).

Method

A systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.

Results

A total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.

Conclusion

There is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.

Declaration of interests

None.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Correspondence: Dr Melanie Lean, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA. Email: mlean@stanford.edu

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Self-management interventions for people with severe mental illness: systematic review and meta-analysis

  • Melanie Lean (a1), Miriam Fornells-Ambrojo (a2), Alyssa Milton (a3), Brynmor Lloyd-Evans (a4), Bronwyn Harrison-Stewart (a5), Amina Yesufu-Udechuku (a6), Tim Kendall (a7) and Sonia Johnson (a8)...
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