No abstract

Cognitive remediation for people with schizophrenia was effective in improving performance on computer exercises, but the benefits of training did not generalize to broader neuropsychological or functional outcome measures. The evidence for this treatment approach remains mixed.

Objective: Many adults with serious mental illness exhibit significant medical illness burden and poor illness self-management. The present study examined Living Well, a group-based illness self-management intervention for adults with serious mental illness, co-facilitated by two providers, one who has lived experience with co-occurring mental health and medical conditions. Methods: Adults with serious mental illness (N=242) were randomized to Living Well or an active control. Participants completed assessments of quality of life, health attitudes, self-management behaviors, and symptoms at baseline, post-treatment, and follow-up. Emergency room use was assessed via chart review. Mixed effects models examined group by time interactions on outcomes. Results: In Living Well, compared to the control, there were greater improvements at post-treatment in mental health related quality of life (t=2.15, df=619, p=.032), self-management self-efficacy (t=4.10, df=622, p<.0001), patient activation (t=2.08, df=622, p=.038), internal health locus of control (t=2.01, df=622, p=.045), behavioral/cognitive symptom management (t=2.77, df=620, p=.006), and overall psychiatric symptoms (t=−2.02, df=603, p=.044), and at follow-up in physical activity related self-management (t=2.55, df=620, p=.011) and relationship quality (t=−2.45, df=603, p=.015). There were no effects on emergency room use (t=0.47, df=480, p=.640). The control group exhibited greater increases in physical health related quality of life at post-treatment (t=−2.23, df=619, p=.026). Significant group differences in self-management self-efficacy (t=2.86, df=622, 0.004) and behavioral/cognitive symptom management (t=2.08, df=620, 0.038) were maintained at follow-up. Conclusions: Compared to an active control, a peer co-facilitated illness self-management group was effective for improving quality of life and self-management self-efficacy in adults with serious mental illness.

The needs and preferences of family members of adults with mental illness are diverse and varied. Consequently, these families may benefit from ongoing provision of information and support tailored to meet the families' individual needs. Continued efforts should be made to understand and address consumer and family needs, potential barriers to participation in family services, and the relationship between stigma and family need.

The needs and preferences of family members of adults with mental illness are diverse and varied. Consequently, these families may benefit from ongoing provision of information and support tailored to meet the families' individual needs. Continued efforts should be made to understand and address consumer and family needs, potential barriers to participation in family services, and the relationship between stigma and family need.