Integrated Illness Management and Recovery: A Program for Integrating Physical and Psychiatric Illness Self-Management in Older Persons with Severe Mental Illness

Older persons with severe mental illness (SMI) are prone to the development of multiple physical illnesses, which are often poorly recognized and treated and which can threaten the quality of their lives, diminish their ability to live in the community, and lead to premature mortality. To address this issue, the Illness Management and Recovery (IMR) program, a standardized program for teaching psychiatric illness self-management skills, was modified to develop the Integrated IMR (I-IMR) program to include the teaching of physical illness self-management by an I-IMR specialist, and medical needs assessment and monitoring provided by an on-site nurse health case manager. A group of 8 older clients with SMI and a comorbid medical condition participated in an open clinical trial to evaluate the feasibility of the program and to explore potential clinical benefits. Participation in the program was high, with 71% of the clients who participated in at least one session completing a total of at least 10 I-IMR sessions. Clients in the program made gains in a variety of areas, including both psychiatric and physical illness self-management, receipt of preventive health care targets, and self-perceived ability to manage their disorders. These encouraging findings suggest that controlled research is needed to more rigorously evaluate the impact of the I-IMR program on medical and psychiatric outcomes in older persons with SMI.