A Crowther1, A Taylor2, R Toney3, S Meddings1, T Whale4, H Jennings5, K Pollock6, P Bates7, C Henderson2,8, J Waring9, M Slade3. 1. Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK. 2. King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, UK. 3. School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, UK. 4. RECOLLECT Lived Experience Advisory Panel, Nottingham, UK. 5. Department of Occupational Therapy, School of Health Sciences, York St. John University, York, UK. 6. School of Health Sciences, University of Nottingham, Nottingham, UK. 7. Peter Bates Associates Ltd, Nottingham, UK. 8. 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. 9. Nottingham University Business School, University of Nottingham, Nottingham, 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.
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.
Entities:
Keywords:
Mechanisms of action; Recovery Colleges; mental health staff; outcomes
Authors: Rebecca Toney; Daniel Elton; Emma Munday; Kate Hamill; Adam Crowther; Sara Meddings; Anna Taylor; Claire Henderson; Helen Jennings; Justin Waring; Kristian Pollock; Peter Bates; Mike Slade Journal: Psychiatr Serv Date: 2018-09-17 Impact factor: 3.084
Authors: Rebecca Toney; Jane Knight; Kate Hamill; Anna Taylor; Claire Henderson; Adam Crowther; Sara Meddings; Skye Barbic; Helen Jennings; Kristian Pollock; Peter Bates; Julie Repper; Mike Slade Journal: Can J Psychiatry Date: 2018-12-30 Impact factor: 4.356
Authors: M Webber; E Corker; S Hamilton; C Weeks; V Pinfold; D Rose; G Thornicroft; C Henderson Journal: Epidemiol Psychiatr Sci Date: 2013-05-20 Impact factor: 6.892
Authors: G Sampogna; I Bakolis; E Robinson; E Corker; V Pinfold; G Thornicroft; C Henderson Journal: Epidemiol Psychiatr Sci Date: 2016-07-28 Impact factor: 6.892
Authors: Rebecca Toney; Jane Knight; Kate Hamill; Anna Taylor; Claire Henderson; Adam Crowther; Sara Meddings; Skye Barbic; Helen Jennings; Kristian Pollock; Peter Bates; Julie Repper; Mike Slade Journal: Can J Psychiatry Date: 2018-12-30 Impact factor: 4.356
Authors: Mike Slade; Stefan Rennick-Egglestone; Laura Blackie; Joy Llewellyn-Beardsley; Donna Franklin; Ada Hui; Graham Thornicroft; Rose McGranahan; Kristian Pollock; Stefan Priebe; Amy Ramsay; David Roe; Emilia Deakin Journal: BMJ Open Date: 2019-06-28 Impact factor: 2.692
Authors: Daniel Hayes; Claire Henderson; Ioannis Bakolis; Vanessa Lawrence; Rachel A Elliott; Amy Ronaldson; Gabrielle Richards; Julie Repper; Peter Bates; John Brewin; Sara Meddings; Gary Winship; Simon Bishop; Richard Emsley; Daniel Elton; Rebecca McNaughton; Rob Whitley; David Smelson; Katy Stepanian; Merly McPhilbin; Danielle Dunnett; Holly Hunter-Brown; Caroline Yeo; Tesnime Jebara; Mike Slade Journal: BMC Psychiatry Date: 2022-09-24 Impact factor: 4.144
Authors: Myra Piat; Megan Wainwright; Marie-Pier Rivest; Eleni Sofouli; Tristan von Kirchenheim; Hélène Albert; Regina Casey; Lise Labonté; Joseph J O'Rourke; Sébastien LeBlanc Journal: Int J Ment Health Syst Date: 2022-10-09