Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries: a cross-sectional survey
Creators: name: Hayes, Daniel
name: Hunter-Brown, Holly
name: Camacho, Elizabeth
name: McPhilbin, Merly
name: Elliott, Rachel A
name: Ronaldson, Amy
name: Bakolis, Ioannis
name: Repper, Julie
name: Meddings, Sara
name: Stergiopoulos, Vicky
name: Brophy, Lisa
name: Miyamoto, Yuki
name: Castelein, Stynke
name: Klevan, Trude Gøril
name: Elton, Dan
name: Grant-Rowles, Jason
name: Kotera, Yasuhiro
name: Henderson, Claire
name: Slade, Mike
name: De Ruysscher, Clara
name: Okoliyski, Michail
name: Kubinová, Petra
name: Eplov, Lene Falgaard
name: Toernes, Charlotte
name: Narusson, Dagmar
name: Tinland, Aurélie
name: Puschner, Bernd
name: Hiltensperger, Ramona
name: Lucchi, Fabio
name: Borg, Marit
name: Tan, Roger Boon Meng
name: Sornchai, Chatdanai
name: Tiengtom, Kim
name: Farkas, Marianne
name: Morland-Jones, Hannah
name: Butler, Ann
name: Mpango, Richard
name: Tse, Samson
name: Kondor, Zsuzsa
name: Ryan, Michael
name: Zuaboni, Gianfranco
name: Hanlon, Charlotte
name: Harcla, Claire
name: Vanderplasschen, Wouter
name: Arbour, Simone
name: Silverstone, Denise
name: Bejerholm, Ulrika
name: Powell, Candice Lym
name: Ochoa, Susana
name: Garcia-Franco, Mar
name: Tolonen, Jonna
name: Dunnett, Danielle
name: Yeo, Caroline
name: Stepanian, Katy
name: Jebara, Tesnime
Publisher: name: La Trobe
Year: 2023
Subjects: classificationCode: 3202
subject: Clinical sciences
classificationCode: 5201
subject: Applied and developmental psychology
classificationCode: 5203
subject: Clinical and health psychology

description: 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&lt;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.