An essential component when providing care for people with chronic illnesses

Because of their high recurrence, experts now consider depressive and anxiety disorders to be chronic illnesses. Supported self-management (SSM) is an essential component in the Chronic Care Model, a standard to strive for when providing care for people with chronic illnesses, both physical and mental. Most clinical practice guidelines also recommend SSM for treating depressive and anxiety disorders (NICE, CANMAT).

SSM helps sufferers become better informed and develop the skills needed to adopt a more active role in their recovery, thus contributing to the effectiveness of primary care interventions. For people suffering from depressive or anxiety disorders, self-management consists particularly of being well aware of their illness, following the progression of their symptoms, participating in making decisions about their treatment, adhering to the chosen treatment, adopting healthy lifestyles, managing social roles soundly and overcoming feelings of powerlessness.

 SSM can take on many forms: bibliotherapy, self-help guides, audiovisual material available online, computerized cognitive behavioural therapy, individual support, SSM groups, etc. and getting support from a caregiver helps increase the efficiency of these various strategies. Several types of caregivers, including general practitioners, nurses, social workers or workers from community agencies specializing in the field, can provide self-management support to people with anxiety and depressive disorders.

This type of intervention can be used in different ways:

• as the main intervention, for example, in the case of mild depression;
• to complement psychotherapy or pharmacotherapy, such as in the case of moderate to severe depression; or
• as a way to prevent relapses.

Although certain studies found SSM to be efficient, there is still much to learn about the specific contents and requirements for obtaining greater clinical efficiency and better cost-effectiveness.