Peer-led self-management for people with severe mental disorders: an economic evaluation

Purpose:- We evaluated the effectiveness and cost-effectiveness of a peer-led self-management intervention for people with severe mental disorders. Design/methodology/approach:- This is a one-arm longitudinal study without control group. 262 adults with (self-reported) severe mental disorders, who have used secondary mental health services and were living in the community, were evaluated at three time-points (baseline, 6 months, 12 months). Socio-demographic data were collected at baseline. Wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), functional living skills (Health Promoting Lifestyle Profile II) and service use (Client Service Receipt Inventory) data were assessed over time. Findings:- Self-management for people with severe mental disorders improved well-being and health-promoting lifestyles. After an increase in the short term, costs appeared to decrease in the longer term, although this change was not statistically significant. Due to the lack of a control group, we are unable to attribute those changes to the intervention only. Nevertheless, the self-management intervention appears to warrant further attention on both wellbeing and economic grounds. Originality/value:- Self-management may facilitate recovery, helping to support people with severe mental disorders at no additional cost. Given recent emphasis on recovery, peer workers and self-management, this peer-led self-management approach for people with severe mental disorders appears to have potential

Mental health: future challenges

The aim of the Foresight Project on Mental Capital and Wellbeing(www.foresight.gov.uk) is to advise the Government on how to achieve the best possible mental development and mental wellbeing for everyone in the UK in the future. The starting point of the Project was to generate an understanding of the science of mental capital and wellbeing (MCW) and to develop a vision for how the size and nature of the challenges exposed by the Project could evolve over the next 20 years. To make this analysis tractable, the work was divided into five broad areas: ● Mental capital through life ● Learning through life ● Mental health ● Wellbeing and work, and ● Learning difficulties. This report presents the findings for “Mental health” and draws upon a comprehensive assessment of the scientific state-of-the art: overall, around 80 reviews have been commissioned across the five areas. Mental health is a term which is used in a number of different ways and which has unfortunately acquired a substantial stigma in all layers of society. While the main focus of this report is on mental ill-health, positive mental health is also vitally important and is also discussed. However, a more comprehensive consideration of positive mental health has been performed in other parts of the Project (as commissioned reviews and in the context of the future of work. This report starts by looking at the situation today, examining the prevalence of important categories of mental disorder. It then considers the risk and protective factors which influence mental ill health, and determines how its prevalence and impact could change in the future, if existing policies and expenditure remain broadly unchanged. An assessment of strategic choices and interventions to meet the future challenges of mental health (and the challenges associated with the other four areas listed above) will be documented in the final Project report which is due for publication in the autumn of 2008