Roudebush VA Medical Center
Health Services Research & Development
Center of Excellence on Implementing Evidence-Based Practice
- Principal Investigator, Michelle P. Salyers, PhD
- Project Director, Alan McGuire, PhD
- Project Manager, Sharon Sidenbender, MA
- Co-Investigator, Marina Kukla, PhD
- Research Assistant, Amethyst Green, BS
- Research Assistant, Zamal Franks, BA
- Research Assistant, Kelsey Bonfils, BS
- Research Assistant, Sylwia Oles
- Richard Frankel, PhD
- Paul Lysaker, PhD
- Kim Mueser, PhD
The President’s New Freedom Commission on Mental Health has called for a transformation of the mental health system to partner with consumers of those services in delivering effective interventions focused on recovery, and the Department of Veterans Affairs (VA) has developed a Mental Health Strategic Plan to address these recommendations. One promising approach is to implement Illness Management and Recovery (IMR), a structured curriculum to help mental health consumers manage their illnesses and pursue goals related to recovery from mental illness. Although IMR is based on practices shown to be effective in controlled research, effectiveness of the comprehensive package of IMR has not yet been demonstrated in a randomized, controlled trial.
The research questions
- The primary objective of the proposed research was to test the effectiveness of IMR as an implementation package.
- Our primary focus was to examine the impact of IMR intervention on consumer outcomes related to illness self-management and recovery.
This was a randomized, controlled trial comparing IMR to an attention control group of mental health treatment in 200 veterans with schizophrenia spectrum disorders. Assessments included semi-structured interviews and standardized measures at baseline, 9 months, and 18 months to assess illness self-management (e.g., symptoms), objective indicators of recovery (e.g., role functioning), and subjective indicators of recovery (e.g., perceptions of well-being). Electronic medical records were accessed to determine the impact of IMR on other service utilization and costs.
IMR was developed from a review of effective approaches for illness self-management training in persons with severe mental illness. The 9-month curriculum was taught using educational, motivational, and cognitive-behavioral techniques, and incorporates five evidence-based practices: education about mental illness, strategies for increasing medication adherence, skills training to enhance social support, relapse prevention planning, and coping skills training.
The program was developed for widespread dissemination and includes a manual, worksheets, an introductory video, a clinical training video, a fidelity scale, and informational brochures for consumers, family members, clinicians, and administrators.