Melanie Lean, Clin.Psych.D. is a post-doctoral research fellow in the INSPIRE clinic. Trained at University College London, Dr Lean is competent in multiple therapeutic modalities, namely Cognitive Behavioural Therapy (CBT) (including CBT for psychosis), Acceptance and Commitment Therapy (ACT) and Systemic Family Therapy. She has experience working in co-produced services in the UK at the mental health charity, MIND in Camden, including co-facilitating Hearing Voices and Voice Collective groups to support young people who hear, see or sense things that other’s don’t. Dr Lean has over 15 years’ experience in clinical research, nine of those in mental health working across a range of settings and populations. She has specialized knowledge in self-management and peer support interventions for people with severe mental illness and has experience working alongside service user researchers in the evaluation and delivery of study interventions.
DClinPsy, University College London (UCL), Clinical Psychology (2017)
John Barry, Postdoctoral Faculty Sponsor
Self-management interventions for people with severe mental illness: systematic review and meta-analysis
BRITISH JOURNAL OF PSYCHIATRY
2019; 214 (5): 260–68
Self-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).A systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.A total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.There is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.
View details for DOI 10.1192/bjp.2019.54
View details for Web of Science ID 000465581400004
View details for PubMedID 30898177
View details for PubMedCentralID PMC6499726