Illness management and recovery (IMR) in Danish community mental health centres

Abstract

BackgroundSchizophrenia and bipolar disorder are severe mental illnesses that can have a significant disabling impact on the lives of people. Psychosocial interventions that stress hope and recovery as a part of a multi-dimensional approach are possibly indicated to support people with severe mental illness in facilitating recovery. Illness Management and Recovery (IMR) is a curriculum-based psychosocial intervention designed as structured program with a recovery-oriented approach. The aim of IMR is to rehabilitate people with severe mental illnesses by helping them acquire knowledge and skills in managing their illness and achieve personal recovery goals. Previous randomised clinical trials indicate that IMR can be implemented with a good effect and a high fidelity though further trials are crucial to demonstrate the potential effectiveness of IMR.Methods/DesignThe trial design is a randomised, assessor-blinded, multi-centre, clinical trial of the IMR program compared with treatment as usual for 200 participants diagnosed with schizophrenia or bipolar disorder under the care of two community mental health centres in the Capital Region of Denmark. The primary outcome is level of functioning at the end of treatment. The secondary outcomes are disease symptoms; use of alcohol/drugs; individual meaning of recovery; hope; hospital admissions and out-patient psychiatric treatment at the end of treatment and the abovementioned and level of functioning at follow-up 21 months after baseline.DiscussionIf the results of this trial show IMR to be effective these positive results will strengthen the evidence of IMR as an effective comprehensive psychosocial intervention with a recovery-oriented approach for people with severe mental illness. This will have significant implications for the treatment and recovery of people with severe mental illness.Trial registrationRegistration number NCT01361698.

Integrated IMR for Psychiatric and General Medical Illness for Adults Aged 50 or Older With Serious Mental Illness

“…I-IMR was associated with greater psychiatric illness self-management, consistent with prior randomized trials of IMR (10–12,32,33). Our finding of improved self-management for diabetes but not for other general medical conditions is consistent with studies of older adults without mental illness.…”

Getting psychosocial interventions into mental health nursing practice: a survey of skill use and perceived benefits to service users

“…This transition towards professional emancipation has resulted in experienced mental health nurses seeking post graduate education to enhance their skills, confidence and identity as effective practitioners. Today, a growing number of mental health practitioners including nurses' in the UK (Stern & Sin 2012), Australia (Mullen 2009), New Zealand (Crow et al 2010) and Denmark (Dalum et al 2011) value the broad panoply of skills, knowledge and framework that PSI provides for their practices. Today, a growing number of mental health practitioners including nurses' in the UK (Stern & Sin 2012), Australia (Mullen 2009), New Zealand (Crow et al 2010) and Denmark (Dalum et al 2011) value the broad panoply of skills, knowledge and framework that PSI provides for their practices.…”

Transplanting recovery: Research and practice in the Nordic countries

“…The majority of the literature covered in this review may be seen as focusing on the task of exposing the mental health community to new knowledge, or disseminating such knowledge (Farkas & Anthony, 2007). Although it confirms findings that have previously emerged in the field, only a few examples describe experience with recovery-oriented methods (Färdig et al, 2011a(Färdig et al, , 2011bDalum et al, 2012). It is particularly important to avoid transforming the individual experience into a professionally defined method (Tew et al, 2011) there are many professional practices and system structures which can support the recovery process, as shown in the international Recovery research in the Nordic countries 567 literature (Leamy et al, 2011).…”

“…Of the seven articles covering quantitative studies, three were reports of randomised controlled trials conducted to evaluate the effects of recovery enhancing methods in outpatient psychiatry settings, in this case focusing on the Illness Management and Recovery programme (Dalum et al, 2012;Färdig et al, 2011aFärdig et al, , 2011b. Two of the others reported on cohort studies aimed at following up the extent of recovery in severe mental illness (Arvidsson, 2011;Lauronen et al, 2005), and one reported on a questionnaire study assessing recovery-oriented attitudes of three personnel groups involved in service provision (Klockmo et al, 2012).…”