General introduction 15 consequences of a serious and persistent condition (71, 72). More specifically, for people with SMI, it includes the ability to reduce their susceptibility to relapses and effectively cope with their symptoms. Having knowledge of mental illness to be able to make informed decisions about treatment together with professionals and the ability to reach out for social support are necessary for this (70, 73). Illness management is also referred to as illness self-management, self-care, or simply selfmanagement (71). Various illness management programs, including IMR, have been developed to support individuals with SMIs in improving the course of their illness (5, 56, 65, 71). These interventions aim to facilitate self-determination and well-being, develop fulfilling and valued workplace roles and social connections, and obtain housing (5, 56, 74-76). These programs include providing psychoeducation and teaching skills for informed decision-making on treatment, providing cognitive-behavioral training to support behavioral-tailored medication adherence, teaching social and coping skills to deal with symptoms or stress, learning to recognize early warning signs, developing a relapse prevention plan, and teaching improvement of social support (56, 71). Moreover, they should include a recovery-oriented component of learning to set and work toward personal goals (71). In clinical practice, illness (self) management programs are provided by both professionals and experts by experience. In a systematic review and meta-analysis, 37 trials on various self-management interventions in psychiatry including 5790 participants were evaluated (71). The criteria for inclusion in this study were providing psychoeducation, relapse prevention, coping skills training, medication management, and supporting progress on personal recovery goals. The proposed typology of the included studies was: 1. Illness management and compliance, 2. Bipolar-specific illness management, 3. Transition to the community from the ward, 4. Coping oriented, and 5. Recovery oriented (71). ‘’Illness management and compliance’’ included IMR; “Transition to community from ward” included different modules from Social & Independent Living Skills (SILS) (77-80), and “Recovery oriented” included WRAP (81), Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) (82), and Recovery is Up to You (83). This meta-analysis found that self-management interventions provided benefits in terms of reduction in symptoms and duration of hospitalization and improvement in functioning and quality of life at both the end of treatment and at follow-up. Overall, effect sizes ranged from small to medium. Evidence for the effect of selfmanagement interventions on readmissions was mixed. However, self-
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