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Articles   |    
A Systematic Review of Self-Management Health Care Models for Individuals With Serious Mental Illnesses
Erin L. Kelly, Ph.D.; Karissa M. Fenwick, L.C.S.W.; Nicholas Barr, M.S.W.; Heather Cohen, M.A.; John S. Brekke, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300502
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The authors are with the School of Social Work, University of Southern California, Los Angeles (e-mail: elk_006@usc.edu). Dr. Kelly is also with the Semel Institute, University of California, Los Angeles.

Copyright © 2014 by the American Psychiatric Association

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Abstract

Objective  The general medical health of individuals with serious mental illnesses is compromised relative to those without serious mental illnesses. To address this health disparity, numerous integrated care strategies are being employed from the system level to the level of individual patients. However, self-management of health care, a strategy considered an integral aspect of typical care, has been infrequently included in interventions for this population. Despite reservations about the capacity of those with serious mental illnesses to self-manage health care, a subset of new interventions focused on general medical health in this population has tested whether models including self-management strategies have empirical support. To understand whether these models are supported, the authors reviewed the evidence for self-management models.

Methods  This systematic review examined collaborative and integrated care models that include self-management components for individuals with serious mental illnesses.

Results  Across the 14 studies identified in this review, promising evidence was found that individuals with serious mental health issues can collaborate with health professionals or be trained to self-manage their health and health care. The evidence supports the use of mental health peers or professional staff to implement health care interventions. However, the substantial heterogeneity in study design, types of training, and examined outcomes limited conclusions about the comparative effectiveness of existing studies.

Conclusions  This review found preliminary support that self-management interventions targeting the general medical health of those with serious mental illnesses are efficacious, but future work is needed to determine what elements of training or skills lead to the most salient changes.

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