Title: Recovery Colleges Characterisation and Testing (RECOLLECT) 2
Funder: Department of Health and Social Care

Abstract: 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.

Lay abstract: Purpose The aim of the proposed research is to find out how Recovery Colleges can provide the most benefit to people to who use mental health services. This will help commissioners decide whether to fund them, managers decide how to run them, and students decide whether to attend. Background In England, there are 77 Recovery Colleges that provide a particular kind of adult education. Each course is designed by service users, carers and mental health staff, and classes are attended by a similar mix of people. Colleges aim to support service users to manage their condition and live a full life. In a previous study called RECOLLECT 1, we collected evidence from managers at 39 Recovery Colleges and from students and other staff at three Recovery Colleges. We measured Recovery Colleges against a quality standard; compared students who use Trust services with Trust service users as a whole; and recorded what students experience at Recovery Colleges and how they benefit from them. Now we want to test whether students at Recovery Colleges with a higher quality standard experience more benefit than those at other Recovery Colleges; whether Recovery Colleges provide value for money compared to just using other Trust services; and what influences they have on Trust staff, services and their local communities. Our research We will collect evidence through: A written survey of Recovery Colleges in England about how they are organised and funded. We will also interview managers, trainers and students at six recovery colleges to explore how the College is organised and how they think this might influence its effectiveness. Selecting 25 colleges that represent all 77. At each of these Colleges, we will engage 25 of their new students in our research. We will ask them to fill out a questionnaire as they register with the College, and again after 4, 8, and 12 months. Comparing samples of Recovery College students with similar mental health service users who do not attend the Recovery College. This will show whether Recovery College students experience additional benefits or make less use of mental health services. Public Involvement We have worked for the past three years with a Lived Experience Advisory Panel (LEAP), who will meet quarterly throughout our study. Members will: help to select the best questionnaires to use; co-design information for students; have the option of interviewing and making sense of data alongside the study team; and assist with publicising the findings. Sharing the findings We will publicise findings through: The final report to NIHR Recovery Colleges International Recovery College Community of Practice Events to share findings with Commissioners and Trust managers. Service user, carer, professional and research networks Academic journals, practitioner journals, and conference presentations

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH