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Self Help and Self Management

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Introduction
Publications
Research and Practice
Videos and Presentations
Organisations
Links


Introduction

Self-help groups for mental health provide mutual support and peer support. Mutual support is a process by which people voluntarily come together to help each other address common problems. Peer support is social, emotional or instrumental support that is mutually offered or provided by persons with similar mental health conditions where there is some mutual agreement on what is helpful.

Although the concept of recovery from a mental illness is relatively new (Deegan, 1988), people with mental health difficulties have been self-managing and functioning in the community long before the idea of recovery became popularized (Harding, Brooks, Ashikaga, Strauss, & Breier, 1987). People with psychiatric diagnoses have countless ways of “getting on with their lives” (Allott, Loganathan, & Fulford, 2002), which have begun to be documented and formalized over the past two decades.

Studies show that self-management --or a person’s determination to get better, manage the illness, take action, face problems, and make choices -- facilitates recovery from mental illnesses (Allott et al., 2002). Self-managed care strategies are as varied as people themselves, but some common techniques include: writing down or talking about problems, contacting or visiting with friends, exercising, praying/meditating, creative endeavors, practicing good nutrition, and engaging in self-advocacy (Rogers & Rogers, 2004). For many, voluntarily taking psychotropic medications and using formal services are aspects of self-managed care as well. In fact, it can be argued that self-management of psychiatric illnesses is at the heart of consumer-directed mental health treatment.

Several manualized self-management programs have been developed in recent years, but perhaps the most widely disseminated is Mary Ellen Copeland’s Wellness Recovery Action Planning known as WRAP (Copeland 1997). WRAP is a program in which participants identify internal and external resources for facilitating recovery, and then use these tools to create their own, individualized plan for successful living (Copeland 1997). The creation of a WRAP plan generally begins with the development of a personal Wellness Toolbox, consisting of simple, safe, and free or low-cost self-management strategies such as a healthy diet, exercise, sleep patterns, and pursuit of adult life roles (Copeland 2004). The person then uses this Toolbox to create an individualized plan for using each strategy to obtain and maintain their recovery. The plan includes identification of “early warning signs” of symptom exacerbation or crisis, and how the Toolbox can help people to manage and feel better. WRAP also encourages development of a crisis plan, which states how the person would like to be treated in times of crisis (similar to an advance directive for inpatient psychiatric care), as well as a post-crisis plan for getting back on the road to recovery.

Since mental illness self-management programs lie at the heart of consumer-directed care, it is not surprising that they are highly similar in their philosophy and intended outcomes to patient-centered medical care as identified by the Institute of Medicine (IOM) in its “Crossing the Quality Chasm” report (IOM, 2001). The goal of both types of programs is health-related behavioral and attitudinal change, with attention to acquiring new information and skills to better manage troublesome symptoms and maintain higher levels of health and functioning. The use of structured techniques and strategies for managing illness and ongoing self-assessment and self-monitoring are also considered active ingredients in both approaches.
(Mental Illness Self-Management Through Wellness Recovery Action Planning, Judith Cook Ph.D.)

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Publications (date ordered)

Take Control - Self-management in care and treatment planning Self-management for people with long-term mental health problems. The Mental Health Foundation, in collaboration with Hafal and Bipolar UK (2012) Terry Davies says: “Having a long term mental health diagnosis is challenging enough without the added pressures of everyday life. Learning self-management was a revelation to me. It taught me to recognise the triggers and early warning signs that might precede an episode of illness, and what action to take in order to stop it in its tracks. I am now able to work, maintain and enjoy a healthy marriage with my wife and be a good father to my three children.

Self-management of mental health problems WHO Regional Office for Europe   Empowerment in Mental Health – Working together towards Leadership   A  meeting in partnership with the European Commission Hosted by EUFAMI    27‐28 October 2010, Leuven, Belgium. This paper sets out our current understanding of self-management among mental health service users and how this relates to empowerment. It provides a brief summary of some of the more recent literature and evidence, cites some examples of existing national policies that have an impact on self-management and identifies potential ways forward.

Wellness Recovery Action Plan Copeland, M. E. (1997) Dummerston, VT: Peach Press

Self Help Leaflets Northumberland, Tyne and Wear NHS
Our self help guides are available to download in several formats. Information available on Abuse, Alcohol, Anxiety, Bereavement, Controlling Anger.  

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Research and Practice (Date ordered)

Recovery, self management and the expert patient – Changing the culture of mental health from a UK perspective Laurie Davidson, Journal of Mental Health, February 2005; 14(1): 25 – 35 Devon Partnership NHS Trust, Wonford House Hospital, Exeter, UK

Self-determination for people with psychiatric disabilities: Personal obstacles and facilitators Rogers, J., & Rogers S. (2004) In J. Jonikas & J. A. Cook (Eds.), UIC NRTC’s National Self-Determination and Psychiatric Disability Invitational Conference: Conference Papers (pp. 7-23). Chicago, IL: UIC National Research and Training Center on Psychiatric Disability

Self-determination in mental health recovery: Taking back our lives Copeland, M. E. (2004) In J. Jonikas & J. Cook (Eds.), UIC NRTC’s National Self-Determination and Psychiatric Disability Invitational Conference: Conference Papers (pp. 68-82). Chicago, IL: UIC National Research and Training Center on Psychiatric Disability.

Wellness Recovery Action Plan: WRAP evaluation Buffington, E. (2003) State of Minnesota. Minneapolis, MN: Mental Health Consumer/Survivor Network of Minnesota.

Discovering hope for recovery Allott, P., Loganathan, L., & Fulford, K. W. M. (2002).  Canadian Journal of Community Mental Health, 21(2), 13-34.

Self-determination for people with psychiatric disabilities: Personal obstacles and facilitators Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C., National Academy Press.

Recovery: The lived experience of rehabilitation Deegan, P. E. (1988). , Psychosocial Rehabilitation Journal, 11(4), 11-19.

The Vermont longitudinal study of persons with severe mental illness: I. Methodology, study sample, and overall status 32 years later, American Journal of Psychiatry, 144, 727-735. Harding, C. M., Brooks, G. W., Ashikaga, T., Strauss, J. S., & Brier, A. (1987).

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Videos and Presentations

What is Self-Management? Self-management helps people with mental health problems take more control over their lives. David Crepaz-Keay explains why self-management is important in helping individuals to have the kind of life that they want. Mental Health Foundation provide self-management courses for people with mental health problems, which enables people to get support from other members of their course as well as from mental health professionals.

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Organisations

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Links

Self Management of Mental Ill -Health  Guide from the Mentaql Health Foundation Self-management is about the methods, skills, and strategies we use to effectively manage our own activities towards achieving certain objectives. For those of us who live with long-term mental health conditions, this means concentrating on interventions and developing training and skills to take care of - and gain direct control over - our lives.

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