Illness management and recovery in community practice

Area of Science:

• Mental Health Services Research
• Psychiatric Rehabilitation
• Evidence-Based Practice Implementation

Background:

• Illness Management and Recovery (IMR) is an evidence-based self-management program for individuals with severe mental illness.
• Effective implementation of IMR is crucial for improving patient outcomes.
• Assessing provider competence and the impact of implementation supports is vital for optimizing IMR delivery.

Purpose of the Study:

• To evaluate provider competence in delivering Illness Management and Recovery (IMR).
• To investigate the association between implementation supports and IMR competence among providers.
• To identify specific IMR elements requiring improvement in community settings.

Main Methods:

• Analysis of IMR session recordings from 43 providers/provider pairs using the IMR Treatment Integrity Scale.
• Provider self-report on the receipt of common implementation supports (e.g., training, consultation).
• Quantitative assessment of IMR competence scores and correlation with support utilization.

Main Results:

• Average IMR competence scores fell within the "needs improvement" range.
• Low competence was observed in significant other involvement, action planning, follow-up, cognitive-behavioral techniques, and medication management tailoring.
• Motivational interviewing training was linked to improved action planning and review competence, but overall, supports showed limited association with competence.

Conclusions:

• IMR implementation in community settings often lacks adequate provider competence.
• Existing implementation supports appear insufficient to enhance IMR skills.
• Additional, targeted implementation supports are necessary to address identified clinician growth areas and improve IMR effectiveness.