Illness Management and Recovery: A Review of the Research

Department of Psychiatry, Dartmouth Medical School and the New Hampshire-Dartmouth Psychiatric Research Center, Concord, New Hampshire 03301, USA.
Psychiatric Services (Impact Factor: 2.41). 11/2002; 53(10):1272-84. DOI: 10.1176/
Source: PubMed


Illness management is a broad set of strategies designed to help individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, and cope effectively with their symptoms. Recovery occurs when people with mental illness discover, or rediscover, their strengths and abilities for pursuing personal goals and develop a sense of identity that allows them to grow beyond their mental illness. The authors discuss the concept of recovery from psychiatric disorders and then review research on professional-based programs for helping people manage their mental illness. Research on illness management for persons with severe mental illness, including 40 randomized controlled studies, indicates that psychoeducation improves people's knowledge of mental illness; that behavioral tailoring helps people take medication as prescribed; that relapse prevention programs reduce symptom relapses and rehospitalizations; and that coping skills training using cognitive-behavioral techniques reduces the severity and distress of persistent symptoms. The authors discuss the implementation and dissemination of illness management programs from the perspectives of mental health administrators, program directors, people with a psychiatric illness, and family members.

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    • "For personal use only. self-management practices, including providing skills such as psycho-education, behavioral tailoring, and relapse prevention resulted in improved clinical outcomes (Mueser et al., 2002). The components of self-management are also effective in managing re-entry issues in criminal justice populations (Prins & Draper, 2009). "
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    ABSTRACT: Community corrections provide a readjustment venue for re-entry between incarceration and home for inmates in the US corrections system. Our goal was to determine how self-management skills, an important predictor of re-entry success, varied by demographic and risk factors. In this cross-sectional study, we analyzed responses of 675 clients from 57 community corrections programs run by the regional division of the Federal Bureau of Prisons. A self-administered survey collected data on self-management skills, demographics, and risk factors; significant associations were applied in four regression models: the overall self-management score and three self-management subscales: coping skills, goals, and drug use. Over one-quarter (27.2%/146) of participants had a mental health history. White race, no mental health history and high school education were associated with better overall self-management scores; mental health history and drug use in the past year were associated with lower coping scores; female gender and high school education were associated with better self-management goals; female gender was associated with better self-management drug use scores. Self-management programs may need to be individualized for different groups of clients. Lower scores for those with less education suggest an area for targeted, nurse-led interventions.
    Issues in Mental Health Nursing 02/2015; 36(2):89-95. DOI:10.3109/01612840.2014.956241
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    • "This definition speaks to the complexity of the stigma construct. Similarly, the research literature has identified various aspects related to and sub-components of the stigma construct, including perceived stigma [2-5], self-stigma [6], social distance [3,7], danger/violence [8], helping [8], negativism, as opposed to a belief in recovery [9], and emotional reactions [10] including social responsibility and lack of empathy or comparison towards people with mental illness. Corrigan and colleagues suggest that “stigma related to mental illness represents a significant public health concern because it is a major barrier to care seeking or ongoing treatment participation” [11]. "
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    ABSTRACT: Diminishing stigmatization for those with mental illnesses by health care providers (HCPs) is becoming a priority for programming and policy, as well as research. In order to be successful, we must accurately measure stigmatizing attitudes and behaviours among HCPs. The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) was developed to measure stigma in HCP populations. In this study we revisit the factor structure and the responsiveness of the OMS-HC in a larger, more representative sample of HCPs that are more likely to be targets for anti-stigma interventions. Baseline data were collected from HCPs (n = 1,523) during 12 different anti-stigma interventions across Canada. The majority of HCPs were women (77.4%) and were either physicians (MDs) (41.5%), nurses (17.0%), medical students (13.4%), or students in allied health programs (14.0%). Exploratory factor analysis (EFA) was conducted using complete pre-test (n = 1,305) survey data and responsiveness to change analyses was examined with pre and post matched data (n = 803). The internal consistency of the OMS-HC scale and subscales was evaluated using the Cronbach's alpha coefficient. The scale's sensitivity to change was examined using paired t-tests, effect sizes (Cohen's d), and standardized response means (SRM). The EFA favored a 3-factor structure which accounted for 45.3% of the variance using 15 of 20 items. The overall internal consistency for the 15-item scale (alpha = 0.79) and three subscales (alpha = 0.67 to 0.68) was acceptable. Subgroup analysis showed the internal consistency was satisfactory across HCP groups including physicians and nurses (alpha = 0.66 to 0.78). Evidence for the scale's responsiveness to change occurred across multiple samples, including student-targeted interventions and workshops for practicing HCPs. The Social Distance subscale had the weakest level of responsiveness (SRM <= 0.50) whereas the more attitudinal-based items comprising the Attitude (SRM <= 0.91) and Disclosure and Help-Seeking (SRM <= 0.68) subscales had stronger responsiveness. The OMS-HC has shown to have acceptable internal consistency and has been successful in detecting positive changes in various anti-stigma interventions. Our results support the use of a 15-item scale, with the calculation of three sub scores for Attitudes, Disclosure and Help-seeking, and Social Distance.
    BMC Psychiatry 04/2014; 14(1):120. DOI:10.1186/1471-244X-14-120 · 2.21 Impact Factor
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    • "Recovery usually occurs when people with mental disabilities discover or rediscover their strengths and the opportunities to pursue personal goals and a sense of self that allows them to grow, despite any residual symptoms and difficulties [39]. Several of the women had taken this turning point as the start of their description of how their journey of recovery began. "
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    ABSTRACT: The most serious type of psychiatric disorder in connection with childbirth is postpartum psychosis. With this disorder occasionally follows emotional rejection of the infant which has serious long term effect on mother and child. The aim of this study was to explore the experiences of the recovery process of postpartum psychosis from the women, from the partners of the women, and their next of kin. Interviews were conducted with seven women, who had previously suffered postpartum psychosis, and six of their next of kin. The interviews were transcribed verbatim and analysed using content analysis. TWO CATEGORIES EMERGED: the recovery process and the circumstances of the support provided. The women and their next of kin spoke about the turning point in the illness, their own personal as well as their social recovery, the importance of support not only from relatives and friends, but also from professionals, and the use of medication. However, the key to recovery was an internal decision by the women themselves. Conclusion is that the recovery from this severe mental disorder requires hard work and the key to their recovery was the decision made by the women. This disorder causes a mental darkness to descend, but at the start of the recovery a dim light shines in the dark tunnel. The nursing staff must be made aware that good sleep is important for the psychiatric treatment and that recovery may take a long time. The nurse needs to provide hope and encouragement, as well as help the woman to recognise the strength that exists within her. To reduce the risk of a recurrence of the disorder, the staff needs to offer follow up visits.
    The Open Nursing Journal 02/2014; 8:8-16. DOI:10.2174/1874434601408010008
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