Self-management interventions for severe mental ill-health aim to improve people’s knowledge, skills and confidence to manage their condition. Core components commonly include relapse prevention planning, psychoeducation, coping strategies and goal setting. There is evidence that these interventions can improve clinical, psychosocial and service use outcomes. Peer support workers, who draw on their lived experience, are particularly well placed to help individuals engage in self-management strategies and build their skills. However, there is limited understanding of how peer workers support and think about self-management in practice. It is also unclear whether commonly used self-management questionnaires reflect what peer-supported self-management involves.
Peer workers described self-management as client-led, relational and focused on building confidence and practical everyday skills. Support included helping people develop routines, use simple coping strategies and strengthen their sense of agency. Assessment relating to a person’s self-management when facilitated by a peer worker was primarily conversational, with questionnaires used infrequently to prompt reflection. The two self-management questionnaires discussed in this study were seen as capturing different aspects of self-management, with one emphasising activation, responsibility and behavioural management, and the other focusing on recovery and perceived mastery. The suitability of the measures within peer work was viewed as dependent on the stage of care. Some adjustments to language were suggested for the measure that emphasised activation.
Self-management in peer support is a collaborative and flexible process that should not be reduced to rigid measurement. Services that employ peer workers may consider selecting self-management measures based on purpose and stage of recovery. When used conversationally rather than administratively, peer workers described the measures as having the potential to support reflection and planning.