Serious Mental Illness (SMI)

SMI exacts a high toll on society, both in terms of direct and indirect costs of health care, lost productivity, and the suffering of afflicted individuals and their families. Mental health provider organizations are charged with transforming the services they provide to improve the outcomes of people with SMI. An increasingly important component of these services are intensive, evidence-based rehabilitation interventions that improve illness self-management, functioning, and quality of life. However, dissemination of these interventions has been limited as community mental health agencies often lack sufficient clinician time and expertise.

The Illness Management and Recovery (IMR)

IMR is a curriculum-based program that enables clients to set and achieve personal recovery goals and acquire the knowledge and skills necessary to manage their illnesses independently. In 2006, SAMHSA released a revised version of the IMR toolkit. IMR was developed as part of the National Implementing Evidence-Based Practices Project and is comprised of four evidence-based practices: psychoeducation, cognitive-behavioral approaches to medication adherence, relapse prevention and coping skills training.

IMR’s Evidence-Based Practices*

These four evidence-based practices are implemented within the context of ten topic areas: recovery strategies, facts about mental illness, stress-vulnerability, building social support, medication management, drug and alcohol use, relapse prevention, coping with stress, coping with problems and symptoms, and getting needs met in the mental health system.

IMR’s Evidence-Based Practices*
Psychoeducation Provides information to consumers and family/community support persons about mental illness, including the:
  • Effects of stress
  • Symptoms
  • Diagnosis, and Treatments
Cognitive-Behavioral Methods (for using medication effectively) Includes:
  • Motivational interviewing
  • Behavioral tailoring
Relapse Prevention Teaches consumers to recognize:
  • Environmental triggers of relapses
  • Early warning signs that symptoms may be worsening
Coping Skills Training Teaches cognitive-behavioral techniques to manage stress and reduce the severity and distress of persistent symptoms.
*see Mueser et al., 2002

Substance Abuse and Mental Health Services Administration (SAMHSA)

IMR is the first comprehensive, evidence-based, self-management training program selected by SAMHSA (Substance Abuse & Mental Health Services Administration) for national dissemination. SAMHSA is a division of the US Department of Health and Human Services.

Paper-Based IMR

The paper-based IMR program (e.g. workbooks and manuals) has been implemented in demonstration projects in several states. However, it has proven relatively labor intensive and costly for many public health programs. In addition, the accessibility of the paper-based IMR program is limited by the number of trained clinicians who can efficiently provide the intervention.


NeuroComp Systems is now developing a computerized, web-based version of the IMR program. This is effort is supported by the National Institute of Mental Health (NIMH), in partnership with IMR developers and the RAND Corporation. IMR-Web has the potential to efficiently support broad utilization of IMR, improve standardization of IMR delivery, and enhance consumer involvement, while reducing resource requirements for provider organizations. IMR-Web will track client progress and help clinicians better identify challenges to address during visits. IMR-Web does not replace clinicians, but will substantially reduce the demands for clinician time.

Advantages of a web-based IMR include:
  1. Electronic data capture at the point of contact with consumers/patients.
  2. Integration with electronic medical record systems.
  3. Centralized IMR program management, database and reporting services.
  4. Remote televideo service enabling IMR clinical practitioners to conduct IMR sessions individually and in groups through a wideband web connection.
  5. An IMR-specific electronic health record (EHR) enables long term progress monitoring and provider management.

IMR-Web Implementation

IMR-Web will be implemented by an enterprise-scale IT infrastructure designed to meet the needs of consumers and providers.

IMR-Web Advisory Board

Chinman, Matthew J., Ph.D.
Behavioral Scientist
RAND Corporation

Gingerich, Susan L., M.S.W.
Independent Consultant
IMR Training and Consultation

Mueser, Kim I., Ph.D.
  O’Halloran, James P., Ph.D.
Principal Investigator & President
NeuroComp Systems, Inc.

Salyers, Michelle P., Ph.D.
ACT Center of Indiana

Young, Alexander S., M.D., M.S.H.S.
Director, Health Services Unit