Recovery Colleges Characterisation and Testing (RECOLLECT) 2

Research questions What are the effectiveness and cost-effectiveness of Recovery Colleges (RCs) in England, and how can RCs be optimised to maximise their benefit to mental health service users? Background Seventy-seven RCs across England provide adult education to mental health service users, carers and staff, to support personal recovery (living as well as possible) and the recovery orientation of staff and affiliated services (supporting illness self-management and community participation). They are run jointly by mental health professionals and people with personal experience of mental illness. Their effectiveness and cost-effectiveness are unknown. In the RECOLLECT 1 PDG, we developed a RC fidelity measure, a change model for service user student outcomes, and undertook casemix analysis of service user students using Trust data. Aims and Objectives To address the research questions above we propose a mixed-methods programme of observational studies structured into Work Packages (WPs) to meet 11 objectives: WP1 National survey 1. Describe RCs in England 2. Establish RC costs. WP2 Prospective pre-post study 3. Investigate changes over time in student outcomes for an inception cohort across multiple RCs 4. Explore relationships between fidelity and outcomes 5. Refine the RECOLLECT 1 change model for service user students WP3 Prospective controlled study 6. Assess effectiveness of RCs 7. Assess cost-effectiveness of RCs WP4 Retrospective controlled study 8. Examine the relationship between RC use and routinely-collected NHS data on (a) outcome and (b) resource use. WP5 Organisational case studies 9. Elaborate contextual and organisational factors influencing fidelity and outcomes. 10. Finalise the RECOLLECT programme theory. WP6 Knowledge mobilisation 11. Mobilise the knowledge generated to maximise RC effectiveness and coverage. Methods WP1 involves a national survey of RC managers (n=77) to complete the fidelity measure and provide data for WPs 3 and 5. WP2 is a prospective, longitudinal pre-post study of service user student outcomes and service use across 25 RCs. Students recruited at registration will be followed up at 4, 8 and 12 months. WP3 is a prospective study comparing outcome and service use between RC students and propensity score matched controls identified through linkage of RC student registration data with Clinical Records Interactive Search (CRIS). WP4 is a retrospective study using routine clinical data to compare outcomes and resource use between RC students and propensity score matched controls, using linkage of RC student registration data with CRIS. WP5 comprises qualitative case studies of six RCs. WP6 comprises multiple forms of targeted communication to stakeholders and measurement of impact. Anticipated Impact and Dissemination The programme will achieve patient benefit as follows: 1: Optimising RC quality through use of the fidelity measure 2: Application of the RECOLLECT programme theory will increase RC efficiency. 3: If the evidence on effectiveness and cost-effectiveness is positive, this justifies increased RC access for service users. 4: Staff who attend the college as students or trainers change their practice, e.g. increased use of shared decision making 5: Organisations affiliated with RCs increase co-production and Trusts increase their peer workforce. 6: Public stigma reduction through contact with peer workforce.