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Mental Health

Editor's Message: Self-Management

Eric Macnaughton

Reprinted from "Self-Management" issue of Visions Journal, 2003, 1 (18), p. 2

Illness management, self-care, or just self-management: all of these are terms that describe essentially the same thing. But just what is it? As you read through this issue of Visions, some of you may feel that the material sounds familiar, and that we’re not talking about anything particularly new. Others may believe that for health conditions as daunting as mental illnesses can be, that a person can’t really manage or control their illness in any significant way. Still others may worry that what self-management implies might be an excuse for governments to reduce funding (after all, if people are self-reliant, then they don’t really need services — or so we may worry).

Self-management is a term that comes from other health conditions which, like mental illness, may be recurring and perhaps life-long conditions (e.g., diabetes, arthritis, asthma etc.). But the concepts of self-management are embedded in many areas of mental health care, under different names. Whether you’re involved in the self-help movement, in psychosocial rehabilitation or with the field of cognitive-behavioural therapy, all of you will recognize the underlying concepts and approaches that we’ll talk about in this edition of Visions. The value of the self-management concept, then, is not necessarily that it’s new, but that it provides a unifying framework for a number of complementary ideas and a framework for harnessing them in the same direction.

What is the purpose, then? As the articles and the guest editorial by Dr. Dan Bilsker suggest, self-management means, first of all, having a basic level of knowledge or literacy about mental health and illness, and a degree of know-how when it comes to accessing help when a mental health problem presents itself in one’s midst. Next, it involves some more advanced knowledge about the particular health condition in question, the kind of knowledge that can facilitate being able to work in partnership with a health professional to find an approach that works.

Knowledge is also a building block for the skills necessary for managing symptoms outside the mental health professional’s office. The kind of skills we’re talking about here include the ability to maintain a healthy lifestyle and to manage stressful situations, in order to decrease the chances of a repeat episode. While prevention is the ideal, the skills we’re talking about include the ability to recognize early warning signs of relapse, and to develop a plan of action for addressing these if they do appear. As pointed out in more than one article, knowledge leads to skills, but actual self-management abilities depend on confidence and hope that these are actually possible and the belief that they can make a difference.

We believe that self-management is possible; and that it doesn’t mean that a person with mental illness has to go it alone, but instead is a way for the individual to get more out of the services they use. Overall, we see self-management as a powerful framework for a number of complementary approaches that ultimately lead to the same goal: that people with mental illness can control their illness and live the kind of lives they want. We hope you agree.

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