Use this Algorithm to refer patients to free
​self-management education & support

Self-management of chronic illness is an evidence-based practice that is widely used in medicine. It gives patients knowledge and problem-solving skills to cope with their medical condition, maintain higher levels of health and functioning, and enhance emotional well-being. The Institute of Medicine (IOM) recommends that all patients with behavioral health conditions be referred for mental illness self-management education and support. IOM recommends further that patients' preferences for peer support be given high priority, due to its demonstrated effectiveness.

To help primary care providers follow these guidelines, we created an algorithm to guide them in identifying self-management programs that are widely available, many of them virtually. It shows what kinds of knowledge patients need at different stages of developing a mental health condition, self-management programs that provide it, and how to locate these programs. Modeled on the American Diabetes Association's patient education algorithm, our algorithm features peer-delivered self-management programs because of their strong evidence-base and successful use in managing mental health conditions. 

How do I Use the Algorithm?

The algorithm identifies four stages in a patient's experience of emotional distress, whether or not they have a formal diagnosis of mental illness. Types of education needed at each stage are listed, along with programs providing this education both in person and virtually. To use the algorithm, assess where your patient falls, discuss with them what type of education would be helpful, and refer them to specific programs based on their preferences.  Help them find a program at the links below or check with your county or state mental health authority. 

Download and print the algorithm

Learn more about free peer-led mental health self-management programs

The following peer-led education programs are supported by research, demonstrate high patient satisfaction, and are available regionally or nationally. Learn more about each one so that you can match them with your patients’ needs and preferences, and show patients how to access them. 
Depression and Bipolar Support Alliance
​DBSA provides hope, help, support, and education to improve the lives of people who have these mood disorders. DBSA offers peer-based, wellness-oriented support and services when people need them, where they need them, and how they need to receive them—online 24/7, in local support groups, in audio and video formats, or in printed materials.
National Alliance on Mental Illness Peer-to-Peer is a free, eight-session educational program for adults with mental health conditions who are looking to better understand themselves and their recovery. Taught by trained leaders with lived experience, this program includes activities, discussions, and informative videos.
Also check the NAMI web page for your state or local affiliate, since many are now offering virtual support groups.
Wellness Recovery Action Plan®
WRAP® is a self-designed prevention and wellness process that anyone can use to get well, stay well, and make their life the way they want it to be. WRAP helps people to discover simple, safe wellness tools. People also identify upsetting events, early warning signs, and signs that things have gotten much worse, so they can develop action plans for responding constructively. They also create a crisis plan and a post-crisis plan. Most groups are free, but some charge a fee (see below for free resources)
NAMI Connection Recovery Support groups are free, peer-led support groups for any adult who has experienced symptoms of a mental health condition. Participants gain insight from hearing the challenges and successes of others, and the groups are led by trained leaders who've been there. NAMI’s support groups are unique because they follow a structured model to ensure everyone has an opportunity to be heard and to get what they need.
Also check the NAMI web page for your state or local affiliate, since many are now offering virtual support groups.
The Schizophrenia Alliance is a self-help/peer support 6-step program run by and for persons who have schizophrenia or a related illness. The program teaches a process of change through which individuals improve their health and wellness, while striving to reach their full potential.
Recovery International groups use a cognitive-behavioral, peer-to-peer, self-help training system that helps individuals gain skills to lead more peaceful and productive lives.
GROW promotes mental health recovery and personal growth. Peer support meetings include a personal testimony, problem-solving with assignment of practical tasks, reports on progress, and development of new understandings through mutual education.
Hearing Voices groups educate people about their voice hearing, visions, and other unusual experiences. Group members talk freely and without judgment among peers, and they develop a personal framework for understanding and managing their voice hearing.

Download this list to share with your patients.

Support for Mental Health Crisis or Pre-Crisis

During a Crisis

988 Lifeline Chat and Text is a service of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline).
​It connects people with crisis counselors for emotional support and other services.
​
Talk
​Call 988 for support via Lifeline Chat.

Haga clic aquí para acceder al Chat 988 en español.
 
Click here to find specialized 988 crisis support (LGBTQ+, veterans, deaf or hard of hearing). 
​
Text
Text 988 for support via Lifeline Chat.
Chat Online
Visit the 988 web site for online support, starting with a brief survey to connect you with the best crisis counselor for you.
Before a Crisis
Warm Line
National Empowerment Center Warm Line Directory 
Visit the directory
Warm lines provide peers to talk with pre-crisis.

Who Else Can Use the Algorithm?

Mental health clinicians
Substance use counselors
Family members 
Peer supporters
Educators 
​Nurses 
Law enforcement
Social workers 
Anyone else who wants to help

Meet our Algorithm Workgroup

The algorithm was designed by Judith Cook and Jessica Jonikas (UIC Center on Integrated Health Care & Self-Directed Recovery); Peggy Swarbrick and Patricia Nemec (Collaborative Support Programs of New Jersey); Benjamin Druss (Emory University); Matthew Federici (The Copeland Center); Maria Margaglione (Depression and Bipolar Support Alliance); Sarah O'Brien (National Alliance on Mental Illness); and Sherry Jenkins-Tucker and Denise Hardy (Georgia Mental Health Consumers Network). 
Views expressed on this web site do not necessarily represent those of our Center or any federal agency.