Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T12:07:20.126Z Has data issue: false hasContentIssue false

The impact of Recovery Colleges on mental health staff, services and society

Published online by Cambridge University Press:  23 October 2018

A. Crowther
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK
A. Taylor
Affiliation:
King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, UK
R. Toney
Affiliation:
School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, UK
S. Meddings
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK
T. Whale
Affiliation:
RECOLLECT Lived Experience Advisory Panel, Nottingham, UK
H. Jennings
Affiliation:
Department of Occupational Therapy, School of Health Sciences, York St. John University, York, UK
K. Pollock
Affiliation:
School of Health Sciences, University of Nottingham, Nottingham, UK
P. Bates
Affiliation:
Peter Bates Associates Ltd, Nottingham, UK
C. Henderson
Affiliation:
King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, UK Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience and South London and Maudsley NHS Foundation Trust, London, UK
J. Waring
Affiliation:
Nottingham University Business School, University of Nottingham, Nottingham, UK
M. Slade*
Affiliation:
School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, UK
*
Author for correspondence: Mike Slade, E-mail: m.slade@nottingham.ac.uk

Abstract

Aims

Recovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.

Methods

Inductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.

Results

Candidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.

Conclusions

This study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher level impacts, and investigate effectiveness and harms.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al Ramiah, A and Hewstone, M (2013) Intergroup contact as a tool for reducing, resolving, and preventing intergroup conflict. American Psychologist 68, 527542.Google Scholar
Anfossi, A (2017) The current state of Recovery Colleges in the UK: final report. ImROC: Nottingham.Google Scholar
Australian Healthcare Associates (2018) Literature Review to Inform the Development of Recovery Colleges in Western Australia. Melbourne: AHA.Google Scholar
Bourne, P, Meddings, S and Whittington, G (2017) An evaluation of service use outcomes in a Recovery College. Journal of Mental Health DOI: 10.1080/09638237.2017.1417557.Google Scholar
Collins, R, Shakespeare, T and Firth, L (2018) Psychiatrist's views on Recovery Colleges. Journal of Mental Health Training, Education and Practice 13, 9099.Google Scholar
Corker, E, Hamilton, S, Robinson, E, Cotney, J, Pinfold, V, Rose, D, Thornicroft, G and Henderson, C (2016) Viewpoint survey of mental health service users’ experiences of discrimination in England 2008–14. Acta Psychiatrica Scandinavica 134(suppl. 446), 1422.Google Scholar
Cornish, F, Gillespie, A and Zittoun, T (2013) Collaborative analysis of qualitative data. In Flick, U (ed.), Handbook of Qualitative Data Analysis. London: Sage, pp. 7993.Google Scholar
Dorset Wellbeing and Recovery Partnership (2016) WaRP Magazine. http://www.dorsetmentalhealthforum.org.uk/pdfs/WaRP%20Magazine%20September%202016.pdf (accessed 24 April 2017).Google Scholar
Frayn, E, Duke, J, Smith, H, Wayne, P and Robert, G (2016) A voyage of discovery: setting up a recovery college in a secure setting. Mental Health and Social Inclusion 20, 2935.Google Scholar
Gill, K (2014) Recovery Colleges, co-production in action: the value of lived experience in ‘learning and growth for mental health’. Health Issues 113, 1014.Google Scholar
Gillard, S, Gibson, S, Holley, J and Lucock, M (2015) Developing a change model for peer worker interventions in mental health services: a qualitative research study. Epidemiology and Psychiatric Sciences 24, 435445.Google Scholar
Henderson, C, Noblett, J, Parke, H, Clement, S, Caffrey, A, Gale-Grant, O, Schulze, B, Druss, B and Thornicroft, G (2014) Mental health-related stigma in health care and mental health-care settings. The Lancet. Psychiatry 1, 467482.Google Scholar
HM Government (2011) No Health Without Mental Health. Delivering Better Mental Health Outcomes for People of all Ages. London: Department of Health.Google Scholar
Ioannidis, J, Evans, S, Gøtzsche, P, O'Neill, R, Altman, D, Schulz, K and Moher, D (2004). Better reporting of Harms in randomized trials: an extension of the CONSORT statement. Annals of Internal Medicine 141, 781788.Google Scholar
Jennings, H, Slade, M, Bates, P, Munday, E and Toney, R (2018) Best practice framework for Patient and Public Involvement (PPI) in collaborative data analysis of qualitative mental health research: methodology development and refinement. BMC Psychiatry 18, 213.Google Scholar
King, T (2015). An Exploratory Study of Co-Production In Recovery Colleges In The UK. (MSc thesis). University of Brighton.Google Scholar
Lucchi, F, Chiaf, E, Placentino, A and Scarsato, G (2018) Programma FOR: a Recovery College in Italy. Journal of Recovery in Mental Health 1, 2937.Google Scholar
McGregor, J, Repper, J and Brown, H (2014) ‘The college is so different from anything I have done’. A study of the characteristics of Nottingham Recovery College. Journal of Mental Health Training, Education and Practice 9, 315.Google Scholar
McGregor, J, Brophy, L, Hardy, D, Hoban, D, Meddings, S, Repper, J, Rinaldi, M, Roeg, W, Shepherd, G, Slade, M, Smelson, D, Stergiopoulos, V and Group, R (2016) Proceedings of June 2015 Meeting. Recovery Colleges International Community of Practice (RCICoP).Google Scholar
Meddings, S, Campbell, E, Guglietti, S, Lambe, H, Locks, L, Byrne, D and Whittington, A (2015 a) From service user to student: the benefits of Recovery Colleges. Clinical Psychology Forum 268, 3237.Google Scholar
Meddings, S, McGregor, J, Roeg, W and Shepherd, G (2015 b) Recovery colleges: quality and outcomes. Mental Health and Social Inclusion 19, 212221.Google Scholar
Moore, G, Audrey, S, Barker, M, Bond, L, Bonell, C, Hardeman, W, Moore, L, O'Cathain, A, Tinati, T, Wight, D and Baird, J (2014). Process Evaluation of complex Interventions: Medical Research Council Guidance. London: MRC Population Health Science Research Network.Google Scholar
Newman-Taylor, K, Stone, N, Valentine, P, Hooks, Z and Sault, K (2016) The Recovery College: a unique service approach and qualitative evaluation. Psychiatric Rehabilitation Journal 39, 187190.Google Scholar
North Essex Research Network (2014) Evaluation of the Mid Essex Recovery College October – December 2013. NERN: Essex.Google Scholar
Oh, H (2013) The pedagogy of recovery colleges: clarifying theory. Mental Health Review Journal 18, 240.Google Scholar
Parker, S, Dark, F, Newman, E, Hanley, D, McKinlay, W and Meurk, C (2018) Consumers’ understanding and expectations of a community-based recovery-oriented mental health rehabilitation unit: a pragmatic grounded theory analysis. Epidemiology and Psychiatric Sciences doi: 10.1017/S2045796017000749.Google Scholar
Perkins, R and Repper, J (2017) When is a ‘recovery college’ not a ‘recovery college’? Mental Health and Social Inclusion 21, 6572.Google Scholar
Perkins, R, Repper, J, Rinaldi, M and Brown, H (2012) ImROC 1. Recovery Colleges. London: Centre for Mental Health.Google Scholar
Perkins, A, Ridler, J, Hammond, L, Davies, S and Hackmann, C (2017) Impacts of attending recovery colleges on NHS staff. Mental Health and Social Inclusion 21, 1824.Google Scholar
Perkins, R, Meddings, S, Williams, S and Repper, J (2018) Recovery Colleges 10 Years On. Nottingham: ImROC.Google Scholar
Puschner, B (2018) Peer support and global mental health. Epidemiology and Psychiatric Sciences shep27, 413414.Google Scholar
Rinaldi, M and Suleman, M (2012) Care Co-ordinators Attitudes to Self-Management and Their Experience of the Use of the South West London Recovery College. London: South West London and St George's Mental Health NHS Trust.Google Scholar
Sampogna, G, Bakolis, I, Robinson, E, Corker, E, Pinfold, V, Thornicroft, G and Henderson, C (2017) Experience of the Time to Change programme in England as predictor of mental health service users’ stigma coping strategies. Epidemiology and Psychiatric Sciences 26, 517525.Google Scholar
Segal, S and Hayes, S (2016) Consumer-run services research and implications for mental health care. Epidemiology and Psychiatric Sciences 25, 410416.Google Scholar
Shepherd, G and McGregor, J (2016) Recovery Colleges – Evolution or Revolution? In Vlaamse Vereniging Geestelijke Gezondheidszorg: Ghent.Google Scholar
Skipper, L and Page, K (2015) Our recovery journey: two stories of change within Norfolk and Suffolk NHS Foundation Trust. Mental Health and Social Inclusion 19, 3844.Google Scholar
Slade, M (2017) Implementing shared decision making in routine mental health care. World Psychiatry 16, 146153.Google Scholar
Slade, M, Amering, M, Farkas, M, Hamilton, B, O'Hagan, M, Panther, G, Perkins, R, Shepherd, G, Tse, S and Whitley, R (2014). Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry 13, 1220.Google Scholar
Slade, M, McDaid, D, Shepherd, G, Williams, S and Repper, J (2017) ImROC Briefing Paper 14. Recovery: The Business Case. Nottingham: ImROC.Google Scholar
Sommer, J, Gill, K and Stein-Parbury, J (2018) Walking side-by-side: Recovery Colleges revolutionising mental health care. Mental Health and Social Inclusion 22, 1826.Google Scholar
Taggart, H and Kempton, J (2015). The Route to Employment: The Role of Mental Health Recovery Colleges. London: CentreForum.Google Scholar
Thornicroft, G, Mehta, N, Clement, S, Evans-Lacko, S, Doherty, M, Rose, D, Koschorke, M, Shidhaye, R, O'Reilly, C and Henderson, C (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet 387, 11231132.Google Scholar
Toney, R, Knight, J, Hamill, K, Taylor, A, Henderson, C, Crowther, A, Meddings, S, Barbic, S, Jennings, H, Pollock, K, Bates, P, Repper, J and Slade, M (2018 a) Development and evaluation of a Recovery College fidelity measure. Canadian Journal of Psychiatry.Google Scholar
Toney, R, Elton, D, Munday, E, Hamill, K, Crowther, A, Meddings, S, Taylor, A, Henderson, C, Jennings, H, Waring, J, Pollock, K, Bates, P and Slade, M (2018 b) Mechanisms of action and outcomes for students in Recovery Colleges. Psychiatric Services. doi: 10.1176/appi.ps.201800283.Google Scholar
United Nations General Assembly (2017) Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Human Rights Council: New York.Google Scholar
Watson, E (2013) What Makes a Recovery College? A Systematic Literature Review of Recovery Education in Mental Health (MHSC Dissertation). University of Nottingham, Nottingham.Google Scholar
Webber, M, Corker, E, Hamilton, S, Weeks, C, Pinfold, V, Rose, D, Thornicroft, G and Henderson, C (2014) Discrimination against people with severe mental illness and their access to social capital: findings from the Viewpoint survey. Epidemiology and Psychiatric Sciences 23, 155165.Google Scholar
Wikgren, M (2005). Critical realism as a philosophy and social theory in information science? Journal of Documentation 61, 1122.Google Scholar
World Health Organization (2013) Mental Health Action Plan 2013–2020. Geneva: WHOGoogle Scholar
Zabel, E, Donegan, G, Lawrence, K and French, P (2016) Exploring the impact of the recovery academy: a qualitative study of Recovery College experiences. Journal of Mental Health Training, Education and Practice 11, 162171.Google Scholar
Supplementary material: File

Crowther et al. supplementary material

Crowther et al. supplementary material 1

Download Crowther et al. supplementary material(File)
File 48.7 KB