title: Supported self-management: a simple, effective way to improve depression care.
abstract: OBJECTIVE
  To introduce supported self-management (SSM) for depression, examine it through the use of a quality assessment framework, and show its potential for enhancing the Canadian health care system.
  
  
  METHODS
  SSM is examined in terms of quality criteria: relevance, effectiveness, appropriateness, efficiency, safety, acceptability, and sustainability. Critical research is highlighted, and a case study is presented to illustrate the use of SSM with depressed patients.
  
  
  RESULTS
  SSM is defined by access to a self-management guide (workbook or website) plus encouragement and coaching by health care provider, family member, or other supporter. It has high relevance to depression care in Canada, high cost-effectiveness, high appropriateness for most people with depression, and high safety. Acceptability of this intervention is more problematic: many providers remain doubtful of its acceptability to their poorly motivated patients. Sustainability of SSM as a component of mental health care will require ongoing knowledge exchange among policy-makers, health care providers, and researchers.
  
  
  CONCLUSIONS
  The introduction of SSM represents a unique opportunity to enhance the delivery of depression care in Canada. Actively engaging the distressed individual in changing depressive patterns can improve outcomes without mobilizing substantial new resources. Over time, we will learn more about making SSM compatible with constraints on provider time, increasing access to self-management tools, and evaluating the benefit to everyday clinical work.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia. dbilsker@sfu.ca
authors.forename: Dan
authors.initials: D
authors.lastname: Bilsker
authors.forename: Elliot M
authors.initials: EM
authors.lastname: Goldner
authors.forename: Ellen
authors.initials: E
authors.lastname: Anderson
mesh_terms: D002170:Canada; D017028:Caregivers / Q000145:classification / Q000193:education / Q000523:psychology; D003362:Cost-Benefit Analysis; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D003866:Depressive Disorder / Q000191:economics / Q000628:therapy; D005260:Female; D006266:Health Education / Q000379:methods / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000379:methods*; D058996:Quality Improvement; D012648:Self Care / Q000191:economics / Q000379:methods / Q000523:psychology; D012944:Social Support