Self-management eased symptoms, but did not clearly cut trips back to hospital.

The review

1. 01

   Who took part

   5,790 adults with severe mental illness took part in 37 trials, mostly in richer countries. The average age was about 40, and 44 in 100 were women.

2. 02

   What they did

   People kept their usual care and joined a programme of about 12 weeks, mostly in groups. The programme taught them about their illness, how to spot early warning signs, how to cope and what to do next. The other groups got usual care only (19 trials), a waiting list (3) or another kind of help (12).

3. 03

   What happened

   Symptoms dropped more than in the other groups, a little at the end and more a year later. Recovery, confidence and daily life also improved at the end. Going back into hospital did not clearly fall, and the trials often disagreed.

What the review found

1. HelpedOther outcomes

   Across 17 trials, extra self-management cut symptoms more than the other groups at the end.

   • Action: Learn how the problem workstested
   • Action: Make an if-then plan for your obstacletested

   Pooled analysis of 17 studies with 1,979 people · vs people on usual care, a waiting list or other help · ⚠ the studies disagreed a lot; whole programmes were tested, so no single part can be credited

2. HelpedMotivation

   Across four trials, self-management made people more sure they would manage their illness.

   • Action: Learn how the problem workstested
   • Action: Make an if-then plan for your obstacletested

   Pooled analysis of 4 studies with 601 people · vs people on usual care, a waiting list or other help · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

3. HelpedOther outcomes

   Across 11 trials, self-management helped people say they were doing better.

   • Action: Learn how the problem workstested
   • Action: Make an if-then plan for your obstacletested

   Pooled analysis of 11 studies with 1,013 people · vs people on usual care, a waiting list or other help · they rated themselves · ⚠ the studies disagreed a lot; whole programmes were tested, so no single part can be credited

4. No differenceOther outcomes

   Across five trials, self-management did not clearly cut trips back to hospital by the end.

   • Action: Learn how the problem workstested
   • Action: Make an if-then plan for your obstacletested

   Pooled analysis of 5 studies with 771 people · vs people on usual care, a waiting list or other help · behaviour was recorded · ⚠ the studies disagreed a lot; whole programmes were tested, so no single part can be credited

Source