Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries: a cross-sectional survey.
Journal
The lancet. Psychiatry
ISSN: 2215-0374
Titre abrégé: Lancet Psychiatry
Pays: England
ID NLM: 101638123
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
04
05
2023
revised:
16
06
2023
accepted:
22
06
2023
medline:
25
9
2023
pubmed:
23
9
2023
entrez:
22
9
2023
Statut:
ppublish
Résumé
Recovery colleges were developed in England to support the recovery of individuals who have mental health symptoms or mental illness. They have been founded in many countries but there has been little international research on recovery colleges and no studies investigating their staffing, fidelity, or costs. We aimed to characterise recovery colleges internationally, to understand organisational and student characteristics, fidelity, and budget. In this cross-sectional study, we identified all countries in which recovery colleges exist. We repeated a cross-sectional survey done in England for recovery colleges in 28 countries. In both surveys, recovery colleges were defined as services that supported personal recovery, that were coproduced with students and staff, and where students learned collaboratively with trainers. Recovery college managers completed the survey. The survey included questions about organisational and student characteristics, fidelity to the RECOLLECT Fidelity Measure, funding models, and unit costs. Recovery colleges were grouped by country and continent and presented descriptively. We used regression models to explore continental differences in fidelity, using England as the reference group. We identified 221 recovery colleges operating across 28 countries, in five continents. Overall, 174 (79%) of 221 recovery colleges participated. Most recovery colleges scored highly on fidelity. Overall scores for fidelity (β=-2·88, 95% CI 4·44 to -1·32; p=0·0001), coproduction (odds ratio [OR] 0·10, 95% CI 0·03 to 0·33; p<0·0001), and being tailored to the student (OR 0·10, 0·02 to 0·39; p=0·0010), were lower for recovery colleges in Asia than in England. No other significant differences were identified between recovery colleges in England, and those in other continents where recovery colleges were present. 133 recovery colleges provided data on annual budgets, which ranged from €0 to €2 550 000, varying extensively within and between continents. From included data, all annual budgets reported by the college added up to €30 million, providing 19 864 courses for 55 161 students. Recovery colleges exist in many countries. There is an international consensus on key operating principles, especially equality and a commitment to recovery, and most recovery colleges achieve moderate to high fidelity to the original model, irrespective of the income band of their country. Cultural differences need to be considered in assessing coproduction and approaches to individualising support. National Institute for Health and Care Research.
Sections du résumé
BACKGROUND
Recovery colleges were developed in England to support the recovery of individuals who have mental health symptoms or mental illness. They have been founded in many countries but there has been little international research on recovery colleges and no studies investigating their staffing, fidelity, or costs. We aimed to characterise recovery colleges internationally, to understand organisational and student characteristics, fidelity, and budget.
METHODS
In this cross-sectional study, we identified all countries in which recovery colleges exist. We repeated a cross-sectional survey done in England for recovery colleges in 28 countries. In both surveys, recovery colleges were defined as services that supported personal recovery, that were coproduced with students and staff, and where students learned collaboratively with trainers. Recovery college managers completed the survey. The survey included questions about organisational and student characteristics, fidelity to the RECOLLECT Fidelity Measure, funding models, and unit costs. Recovery colleges were grouped by country and continent and presented descriptively. We used regression models to explore continental differences in fidelity, using England as the reference group.
FINDINGS
We identified 221 recovery colleges operating across 28 countries, in five continents. Overall, 174 (79%) of 221 recovery colleges participated. Most recovery colleges scored highly on fidelity. Overall scores for fidelity (β=-2·88, 95% CI 4·44 to -1·32; p=0·0001), coproduction (odds ratio [OR] 0·10, 95% CI 0·03 to 0·33; p<0·0001), and being tailored to the student (OR 0·10, 0·02 to 0·39; p=0·0010), were lower for recovery colleges in Asia than in England. No other significant differences were identified between recovery colleges in England, and those in other continents where recovery colleges were present. 133 recovery colleges provided data on annual budgets, which ranged from €0 to €2 550 000, varying extensively within and between continents. From included data, all annual budgets reported by the college added up to €30 million, providing 19 864 courses for 55 161 students.
INTERPRETATION
Recovery colleges exist in many countries. There is an international consensus on key operating principles, especially equality and a commitment to recovery, and most recovery colleges achieve moderate to high fidelity to the original model, irrespective of the income band of their country. Cultural differences need to be considered in assessing coproduction and approaches to individualising support.
FUNDING
National Institute for Health and Care Research.
Identifiants
pubmed: 37739003
pii: S2215-0366(23)00229-8
doi: 10.1016/S2215-0366(23)00229-8
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
768-779Investigateurs
Clara De Ruysscher
(C)
Michail Okoliyski
(M)
Petra Kubinová
(P)
Lene Falgaard Eplov
(LF)
Charlotte Toernes
(C)
Dagmar Narusson
(D)
Aurélie Tinland
(A)
Bernd Puschner
(B)
Ramona Hiltensperger
(R)
Fabio Lucchi
(F)
Marit Borg
(M)
Roger Boon Meng Tan
(RBM)
Chatdanai Sornchai
(C)
Kim Tiengtom
(K)
Marianne Farkas
(M)
Hannah Morland-Jones
(H)
Ann Butler
(A)
Richard Mpango
(R)
Samson Tse
(S)
Zsuzsa Kondor
(Z)
Michael Ryan
(M)
Gianfranco Zuaboni
(G)
Charlotte Hanlon
(C)
Claire Harcla
(C)
Wouter Vanderplasschen
(W)
Simone Arbour
(S)
Denise Silverstone
(D)
Ulrika Bejerholm
(U)
Candice Lym Powell
(CL)
Susana Ochoa
(S)
Mar Garcia-Franco
(M)
Jonna Tolonen
(J)
Danielle Dunnett
(D)
Caroline Yeo
(C)
Katy Stepanian
(K)
Tesnime Jebara
(T)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declarations of interests RAE has received travel expenses from the University of Brussels as part of Crosstalks for providing a lecture on mental health interventions. VS is a volunteer member of the Board of Inner City Health Associates, a non-for-profit health care organisation providing care to people experiencing homelessness in Toronto. LB has received funding from Mind Australia to evaluate Mind Australia's Haven Homes and from the Australian Capital Territory Recovery College Pilot project. YM has received grants from Grants-in-Aid for Scientific Research and the Health (Japan) and from the Labour Sciences Research Grants (Japan); YM has also received honoraria for talks from the Japan College of Social Work, Tokyo University of Technology, Japan Academy of Psychiatric and Mental Health Nursing, and Japanese Society of Psychiatry and Neurology; and is an unpaid Steering Committee member of Recovery College Ota in Japan. The views expressed are those of the authors and not necessarily those of the National Institute for Health and Care Research (NIHR) or the Department of Health and Social Care.