Lean, M;
Fornells-Ambrojo, M;
Milton, A;
Lloyd-Evans, B;
Harrison-Stewart, B;
Yesufu-Udechuku, A;
Kendall, T;
(2019)
Self-management interventions for people with severe mental illness: a systematic review and meta-analysis.
British Journal of Psychiatry
, 214
(5)
pp. 260-268.
10.1192/bjp.2019.54..
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Abstract
BACKGROUND: Self-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps to recognise and manage 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). // METHODS: 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: Thirty-seven trials were included with 5790 participants. From the metaanalysis, 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 to 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 severe mental illness. Self-management interventions should form part of the standard package of care provided to people with severe mental illness and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.
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