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

Abstract

AimsRecovery 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.MethodsInductive 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.ResultsCandidate 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.ConclusionsThis 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.

Development and Evaluation of a Recovery College Fidelity Measure

“…This research was undertaken as part of the Recovery Colleges Characterisation and Testing (RECOLLECT) Study (researchintorecovery.com/recollect). Other elements of the RECOLLECT Study have investigated mechanisms of action and outcomes from Recovery Colleges for students 11 and for staff, service, and society, 12 as well as developed a methodology for collaborative data analysis involving people with lived experience. 13 Ethical committee approval for the RECOLLECT Study was obtained (Nottingham REC 1, 18.1.17, 16/EM/0484).…”

A systematic review of influences on implementation of peer support work for adults with mental health problems

“…The most identified influence was organisational culture, and this is an international challenge [48]. Evidence-based approaches are emerging to change organisational culture, including a greater emphasis on supporting strengths [49][50][51], self-management [52], hope [53,54], well-being [55][56][57] and more use of new interventions such as positive psychology [58,59], recovery colleges [60][61][62] and a greater focus on human rights [63]. New measures to evaluate recovery-related outcomes are also becoming available [64,65].…”

Beyond the moment: Influence of a co‐facilitated education intervention on practitioners’ recovery beliefs and practices

“…With the growing recognition of the limitations of recovery education that is decoupled from practice (Crowther et al . 2019; Eiroa‐Orosa & García‐Mieres 2019) and research indicating that there continues to be a tension between policies that espouse recovery and the lived realities of people using mental health services (Slade et al . 2008), finding workable solutions to enhance the development of recovery‐oriented mental health spaces remains a challenge.…”

“…Similarly, Crowther et al . (2019) in a recent systematic review on action and outcomes of recovery colleges report that while recovery colleges impact community attitudes, having developed independently of the mental health services and being more outward facing in their orientation, they have reduced reach and impact on the culture and practice within the mental health services.…”