A co-produced self-management programme improves psychosocial outcomes for people living with depression

AbstractPurpose: There is growing interest in self-management support for people living with mental health problems. This paper describes the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. We investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the 7 week SMP. Design: We conducted a longitudinal survey of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at 6 months follow-up.Findings: Patient activation significantly improved 6 months after the SMP (baseline M=49.6 SD =12.3, follow up M= 57.2, SD =15.0, t(113)=4.83 p<0.001; d =0. 61) Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD= 6.8, follow up M= 10.6, SD= 6.9, t(106)= 7.22 p<0.001, d=-0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD =4.2, follow up M= 10.2, SD=4.4, t(79) =6.29, p<0.001, d= -0.69); (baseline depression: M=10.3, SD=4.6, follow up M= 7.7, SD=4.5, t(79) =5.32, p<0.001,d= -0.56). We also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M= 0.6, SD =0.3, t(97)=-3.86, p<0.001, d=0.33), and health-related quality of life (baseline M=45.4 , SD=20.5, follow up M= 60.8, SD=22.8, t(91) =-2.71 p=0.008, d = 0.75). About 35% of participant showed substantial improvements of self-management skills. Originality/value: The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health. Keywords: Co-production, self-management, patient activation, depression, recovery.