April 2023 | VISN 5 MIRECC Link
Living Well: An intervention to help people better manage common medical and psychiatric challenges
Research Publication:
Muralidharan, A., Brown, C. H., Peer, J. E., Klingaman, E. A., Hack, S. M., Li, L., Walsh, M. B. & Goldberg, R. W. (2019). Living well: An intervention to improve medical illness self-management among individuals with serious mental illness. Psychiatric Services, 70(1), 19-25.
Living Well, a group for people with physical and mental health challenges, helps Veterans better manage their health. People living with a serious mental illness die younger when compared to the general population. This is due in part to high rates of chronic medical conditions and poor lifestyle behaviors. Interventions helping people better self-manage common medical and psychiatric challenges can be helpful. People living with medical and psychiatric conditions can serve as role models in helping others with similar challenges. Dr. Goldberg and his team developed and tested a 12-session group intervention called Living Well. This intervention is co-led by a person living with both a medical and psychiatric condition and a clinician. The goal of Living Well is to enhance self-efficacy and motivation through education and skills training in action planning and problem solving. Sessions focus on learning about a range of health-related topics. These include: mental health recovery, healthy eating, physical activity, symptom management, and other subjects. Participants also create weekly action plans and engage in group-based problem solving to reach their lifestyle goals. Dr. Goldberg and his team completed a randomized trail comparing Living Well to an active control condition. After completing the study, Veterans receiving the Living Well Intervention reported improvements in attitudes (e.g. self-efficacy) as well as in using illness-self management behaviors. They also reported fewer psychiatric symptoms and improved mental health-related quality of life. No effects were found for emergency room use. Those in the physical wellness education and support control condition reported greater increases in physical health-related quality of life. At 3-month post-treatment follow-up, those receiving Living Well retained significantly greater improvements in self-management and self-efficacy. They also reported greater improvements in physical activity and relationship quality.
What Can Providers Do?
- Ask Veterans about both psychiatric and chronic medical conditions and related challenges.
- Encourage and motivate Veterans to play a more active role in maintaining a healthy lifestyle.
- Maintain a list of lifestyle resources and referrals such as the VA’s Whole Health Whole Health Home (va.gov) and MOVE! Weight Management Programs.
- Know that Peer Specialists provide a credible source of social support for health and wellness self-management.
What Can Veterans and their Families Do?
- Talk to medical and psychiatric providers about lifestyle and wellness self-management behaviors
- Develop knowledge, skills (e.g. action planning, problem solving, healthy eating, symptom management, etc.), and attitudes needed to live a healthier lifestyle and manage both medical and psychiatric conditions.
- Download and use VA’s free and easy to use mobile application, Live Whole Health, to learn more about VA’s holistic approach to care that supports your health and well-being.
