Recipient organisationNottinghamshire Healthcare NHS Foundation TrustSource-published name: Nottinghamshire Healthcare NHS Foundation Trust
Funding£2.3M
PeriodApr 2017 — Sept 2023
In plain English
AI plain-English summary
A large-scale trial across England will test whether giving people with psychosis access to recorded recovery narratives—stories from others who have faced similar experiences—can improve their quality of life over a year. Psychosis is distressing and costly, but many people never meet others who have recovered. Recorded narratives offer a low-cost way to share that experience widely. The research fills a gap: it systematically collects narratives from groups often left out of research, including people not using mental health services and those from non-majority backgrounds. If the intervention works, it could become a simple, scalable online tool for mental health services. Patients would log in and be matched to a narrative most likely to help them, using a machine-learning algorithm refined through the study. The programme also aims to boost hope among healthcare staff by giving them an online resource. Success would mean a practical, low-cost addition to routine care—not a cure, but a way to reduce isolation and improve daily life for thousands of people with psychosis.
View original technical description
Aims and Objectives Recovery narratives involve people describing the understanding they have developed about their mental health problems and their recovery. The aim of this study is to use recorded recovery narratives to support the recovery of people experiencing psychosis. The objectives are: 1. To collect recovery narratives from four under-researched groups (n=120) 2. To develop and validate (n=20) a conceptual framework characterising recovery narratives and their benefits to others 3. To develop (n=40), refine (n=30) and optimise (n=81) an intervention using recorded narratives to benefit people experiencing psychosis 4. To conduct a definitive randomised controlled trial to assess the effectiveness and cost-effectiveness of the intervention on current mental health service users experiencing psychosis from across England (n=683) Hypothesis: participants receiving the narratives intervention will have improved quality of life at one-year follow-up compared with those not receiving the intervention. 5. To develop an online intervention for mental health professionals to increase hopefulness in staff about recovery. Background and rationale Psychosis is burdensome to individuals and their families, and costly to society (see Importance to the NHS section). People experiencing psychosis benefit from meeting others who share their narrative of recovery5, and recorded narratives provide a low-cost approach to increasing access. This programme builds on a previous Programme Grant (RP-PG-0707-10040) on recovery. Research plan The scientific framework is the 2015 MRC Framework for Complex Interventions6. MRC Development Stage Work Package 1 addresses knowledge gaps relating to four important under-researched groups: experiencing psychosis and not using mental health services; mental health service users from non-majority groups; people who are under-served by mental health services; and peer workers. Semi-structured interviews (n=120) will explore how their narratives may benefit others. Work Package 2 synthesises existing research and Work Package 1 findings to develop a conceptual framework characterising the defining features of recovery narratives and the mechanisms by which they benefit others. After further refinement through semi-structured interviews with service users (n=20), this forms the basis for Work Packages 3 and 4. MRC Feasibility/Piloting and Evaluation Stages Work Package 3 develops and evaluates the NEON intervention, an online intervention using recorded recovery narratives for mental health service users experiencing psychosis. English-language narratives will be collated from multiple sources. Guided by Work Package 2, a preliminary matching approach for selecting the most helpful narrative(s) for individuals will be developed, using the Narratives of Recovery Scale (NORSE) to characterise narratives and ratings of hope-promotion from 40 service users to characterise their impact. As further participants use the intervention, the machine-learning approach will refine the matching algorithm. Informed by workshops with 30 healthcare professionals, an online intervention will be developed to match individuals to narratives. Feasibility of trial procedures and engagement approaches will be tested with 30 mental health service users, and clinical relevance maximised through focus groups with health professionals (n=24). A definitive randomised controlled trial with an internal pilot will then be conducted across England, involving 683 mental health service users with a psychosis diagnosis, randomised to either usual care or usual care plus NEON. The intervention will comprise an internet-based experience of recorded recovery narratives, with the narrative chosen using the matching algorithm (recommended approach), by the service user, or randomly presented. The primary outcome is quality of life measure with Manchester Short Assessment. Outcome evaluation will use intention-to-trea
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