Living well: an intervention to improve self-management of medical illness for individuals with serious mental illness.
OBJECTIVE
Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness.


METHODS
A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up.


RESULTS
Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant.


CONCLUSIONS
Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.
Department of Veterans Affairs Capitol Health Care Network (VISN 5), Mental Illness Research, Education and Clinical Center, 10 N. Greene St., Baltimore, MD 21201, USA. richard.goldberg@va.gov
Richard W
RW
Goldberg
Faith
F
Dickerson
Alicia
A
Lucksted
Clayton H
CH
Brown
Elyssa
E
Weber
Wendy N
WN
Tenhula
Julie
J
Kreyenbuhl
Lisa B
LB
Dixon
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction; D015397:Program Evaluation / Q000379:methods; D058996:Quality Improvement; D012648:Self Care / Q000592:standards*; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires