Controlled clinical trial of a self-management program for people with mental illness in an adult mental health service – the Optimal Health Program (OHP)
Monica M. Gilbert A H , James A. Chamberlain A , Carolynne R. White B , Paul W. Mayers C , Brendan Pawsey A , Danny Liew D , Matthew Musgrave E , Kerry Crawford F and David J. Castle GA Healthmaps, PO Box 2501, Fitzroy, Vic. 3065, Australia. Email: jameschamberlain@healthmaps.com.au; brendanpawsey@healthmaps.com.au
B Manningham Community Health Service, Unit 1, 1020 Doncaster Road, Doncaster East, Vic. 3109, Australia. Email: carolynne.white@mannchs.org.au
C Mental Health ACT, 1 Moore Street, Canberra, ACT 2601, Australia. Email: paul.mayers@act.gov.au
D Melbourne EpiCentre, Centre for Clinical Epidemiology, Biostatistics and Health Services Research, The Royal Melbourne Hospital, 7 East, Main Building, Grattan Street, Parkville, Vic. 3050, Australia. Email: dliew@medstv.unimelb.edu.au
E Hastings Community Mental Health, Port Macquarie Base Hospital, 14 Wrights Road, Port Macquarie, NSW 2444, Australia. Email: matthew.musgrave@ncahs.health.nsw.gov.au
F Consultation Liaison Psychiatry, The Canberra Hospital, 6 Waite Street, Farrer, Canberra, ACT 2607, Australia. Email: kerry.crawford@act.gov.au
G University of Melbourne, St Vincent’s Hospital, Department of Psychiatry, St Vincent’s Mental Health Service, PO Box 2900, Fitzroy, Vic. 3065, Australia. Email: david.castle@svhm.org.au
H Corresponding author. Email: monicagilbert@healthmaps.com.au
Australian Health Review 36(1) 1-7 https://doi.org/10.1071/AH11008
Submitted: 10 February 2011 Accepted: 25 July 2011 Published: 24 February 2012
Journal Compilation © AHHA 2012
Abstract
Objective. The objective of this study was to evaluate the effect and cost-effectiveness of a self-management intervention, delivered as part of routine care in an adult mental health service.
Method. In a community mental health setting, routine care was compared with routine care plus a nine-session intervention (the Optimal Health Program) using a non-randomised controlled design. Adult (18–65 years) consumers of mental health services in the Australian Capital Territory were eligible for participation.
Results. The Optimal Health Program was associated with significant improvements in health and social functioning as measured by the Health of the Nation Outcome Scale (average change relative to control: –3.17; 95% CI –4.49 to –1.84; P < 0.001). In addition, there was a reduction in hospital admissions in the treatment group (percentage of time in hospital reduced from 3.20 to 0.82; P = 0.07). This translated into a net cost saving of over AU$6000 per participant per year (uncertainty range AU$744 to AU$12 656).
Conclusions. This study shows promising results for incorporating a self-management program into routine care to improve the health and social functioning of mental health consumers in a cost-effective manner.
What is known about the topic? Current literature supports the efficacy of structured self-management programs for chronic conditions such as diabetes (type 1 and 2) and asthma, but there remains limited evidence that self-management programs improve outcomes for people with mental illness.
What does this paper add? This study adds to the body of evidence supporting self-management as a cost-effective adjunct to routine care in mental health services.
What are the implications for practitioners? Our study supports the feasibility of clinicians delivering cost-effective self-management programs as part of routine mental health service delivery.
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