Implementation of Self Management for Mental Health Populations

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Implementation of Self Management for Mental
Health Populations

• Trainers of Excellence Advancing the Way
  Forward
• 27th 28th August, 2007, Adelaide
• Dr Sharon Lawn, FHBHRU
• Ph. 08 8404 2321 sharon.lawn_at_fmc.sa.gov.au

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A Particularly Vicious Cycle

• Compounding
• Disability
• Stigma
• Poor detection treatment
• Poor health outcomes

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Assessment of Self-Management

• Knowledge
• Medications and diagnosis
• Supports
• Behaviors
• Insight Compliance
• Early Warning Signs
• Relapse prevention
• CTOs other Orders

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Assessment of Self-Management

• Impacts
• Social, Emotional, Physical
• Strengths
• Several
• Barriers
• Several (interpersonal,
  community, systemic)

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The Noarlunga Project

• One of 4 demonstration projects funded by Health
  Promotion SA (DHS) under a statewide CDSM Project
  initiative
• Eyre - Peninsula Indigenous Diabetes
• TQEH - Cardiac Rehabilitation
• RGH - Lung Disease
• Noarlunga Mental Health

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• Aim
• To develop and trial a generic model of chronic
  illness self management based on assessment of
  self management, peer education and support, and
  collaboration with mental health workers and GPs,
  for people with both mental and physical illness
  living in the community.
• (An international first)

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The Noarlunga Project

• 38 participants
• Stanford program (CCSM Peer Led Groups)
• Flinders Model (Person, GP Key Worker)
• Significant improvement in
• - Partners in Health ratings
• - Problem rating 5.19 3.16 (plt0.001)
• - Goal rating 5.35- 3.55 (plt0.001)
• - Mental Health Summary Score SF12
• Reduced hospital admission rates

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Let Consumers lead the way

• Peer workers as part of core business
• Effective self-management Role Models
• Challenge stigma and resistance to change
  within Services, the Community MHS

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The Benefits of Peer Support

• To Recipients
• To Peer Providers
• To Mental Health Services
• To the Community
• P. Solomon (2004) Psychiatric Rehabilitation
  Journal, Vol 27, No.4, 392-401.

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The Benefits of Peer Support

• Emotional information support
• Buffer against stressors and adversities
• Promotion of choice and self-determination
• Credible role models are more likely to influence
  positive behaviour change
• Establish a sense of normalcy
• Benefit themselves from helping others

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The Benefits of Peer Support

• Improved Symptoms
• Increased participation in social networks
• Quality of Life
• Improved coping greater acceptance of illness
• Improved treatment adherence greater
  satisfaction with health
• Improved self-esteem
• Potential for cost savings with fewer
  hospitalisations
• Altering negative attitudes to mental health
  providers

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More Information on the Mental Health Projects

• Urukalo, M., Lawrence, J. and Lawn, S. (2004)
  Noarlunga Chronic Disease Self Management Project
  An Approach to Improving the Emotional and
  Physical Well Being of People Who Experience
  Chronic Mental Health Problems - Final Report to
  Health Promotion SA, South Australia Department
  of Human Services, http//som.flinders.edu.au/FUSA
  /CCTU/Noarlunga20Final20250805.pdf
• Lawn, S, Battersby, M.W., Pols, R.G., Lawrence,
  J., Parry, T. and Urukalo, M. (2007) The Mental
  Health Expert Patient Findings from a pilot
  study of a generic Chronic Condition
  Self-Management program for people with mental
  illness. International Journal of Social
  Psychiatry, 58, 63-74.
• Lawn, S., Smith, A. Hunter, K. (in press)
  Mental Health Peer Support for Hospital Avoidance
  and Early Discharge An Australian Example of
  Consumer Driven and Operated Service. Journal of
  Mental Health.