WMR Background

Wellness (Illness) Management and Recovery Background

Illness management is a broad set of strategies designed to help individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, and cope effectively with their symptoms. Recovery occurs when people with mental illness discover, or rediscover, their strengths and abilities for pursuing personal goals and develop a sense of identity that allows them to grow beyond their mental illness.

The practice in medicine of professionals teaching persons with medical diseases and their families about the diseases in order to improve adherence to recommended treatments and to manage or relieve persistent symptoms and treatment side effects has a long history. In the mental health field, didactic methods for educating people have been referred to as psychoeducation. Other methods, especially cognitive-behavioral strategies, have also been used to help people learn how to manage their mental illnesses more effectively.
People with psychiatric disorders can be given information and taught skills by either professionals or peers to help them learn ways to manage their illness better. Although the goals of professional-based and peer-based teaching are similar, they have differences. Professional-based intervention is conducted in the context of a therapeutic relationship in which the teacher-or the organization to which the teacher belongs, such as a community mental health center-is responsible for the overall treatment of the individual's psychiatric disorder. In contrast, peer-based intervention is conducted in the context of a relationship in which the teacher-or the organization to which the teacher belongs, such as a peer support center-usually does not have formal responsibility for the overall treatment of the individual's disorder. Given this distinction, the relationship between a professional and the person with a mental illness may be perceived as hierarchical, because the professional assumes responsibility for the person's treatment, whereas the relationship between a peer and the person with a mental illness is less likely to be perceived as hierarchical, because the peer does not assume such responsibility. This distinction is crucial among individuals with psychiatric disorders who have advocated for self-help and peer-based services as alternatives to, or in addition to, traditional professional-based services.

Professional and peer-based services are also different in that most professionals do not have serious psychiatric disorders-in contrast, by definition, to peers. Thus when teaching others how to manage their mental illness, peers are able to convey the lessons they have learned from personal experience, whereas professionals cannot. This places peers in a unique position of being able to teach "self" management skills to other persons with a mental illness.

To recognize these differences, a distinction may be made between professional-based services and peer-based services aimed at helping people deal with their psychiatric disorders. Illness management can be defined as professional-based interventions designed to help people collaborate with professionals in the treatment of their mental illness, reduce their susceptibility to relapses, and cope more effectively with their symptoms. Illness self-management, on the other hand, may be used to refer to peer-facilitated services aimed at helping people cope more effectively with their mental illness and facilitating people's ability to take care of themselves.