A systematic review of the published literature on interventions to improve personal self-care for people with severe mental health problems

Introduction People with severe mental health problems often struggle to manage everyday tasks such as personal hygiene, housework, shopping, cooking and budgeting. These functional problems result in self-neglect and are associated with specific cognitive impairments and poor outcomes. Despite their importance, little guidance is available for practitioners in how to address these problems. Method We conducted a systematic review of the research literature published since 1990 on the effectiveness of interventions that aim to assist people with severe mental health problems to manage their personal self-care. We searched six major electronic databases and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance in the conduct of the review and reporting of results. Results Our search identified 2808 papers of which only eight met our inclusion criteria. The included papers comprised six randomised controlled trials and two 'pre-post' studies reporting on evaluations of five different interventions. We used narrative synthesis to summarise our findings. The strongest evidence was for cognitive adaptation training, comprising environmental supports provided in the home that address the functional problems arising from specific cognitive impairments. Conclusion The paucity of research into interventions to assist personal self-care for people with severe mental health problems is surprising. More research in this area is urgently needed.