Investigating the Meaning and (Cost-)Effectiveness of Dutch Recovery Colleges

Recovery colleges (RC) aim to promote the recovery of people who experience mental vulnerabilities. Rather than facilitating treatment of illness (as regular mental health care services \[MHCS\] do), RCs are learning environments, with a special focus on peer support and co-creation. While MHCS are founded on scientific and professional knowledge, RCs value the knowledge and abilities of those with lived experiences as such. By sharing experiences, RC attendees can inspire and support each other (hence 'peer support') and they can use their experiences to contribute to the educational program (hence 'co-creation'). In the Netherlands RCs are 100% peer run, meaning that no mental health care workers are involved.

Despite promising premature findings on the effectiveness of RC attendance (e.g., positive impacts on MHCS use, mental wellbeing and functioning, quality of life, empowerment and more), large, controlled studies are extremely scarce. Furthermore, the way RCs are managed in the Netherlands seems to differ from the RCs that have been studied before. While RCs in some countries are a coproduction of peers and mental health practitioners, RCs in the Netherlands are 100% peer run, although they are usually hosted by MHCS. In turn, this research project aims to investigate the (cost-)effectiveness of RCs in the Netherlands. In terms of effectiveness, we expect that RC attendance improves feelings of empowerment. Besides, we investigate impacts on quality of life, mental health, loneliness, satisfaction with treatment and support and self-stigma. We also determine the cost-effectiveness of Dutch RCs.

This quantitative study is part of a larger research project that entails qualitative analysis of:

* the meaning of Enik RC for its partakers (the first RC established in the Netherlands in 2015);
* the position that RCs can and should have in the Dutch MHCS landscape;
* a fidelity measure to define the core elements of Dutch RCs and to obtain an overview of the available initiatives in the Netherlands

The research project is executed in close collaboration with co-researchers who are partakers of Enik RC. The findings of the pre-registered quantitative study will be evaluated and contextualized in co-creation as such.

NOTE: The Observational Study Model is both Cohort (monitoring for a period of 2 years) and Case-Control (comparing RC partakers with non-partakers).

NOTE: Enik Recovery College has 7 established locations in the region of Utrecht at the time of our recruitment. All are included.

NOTE: Fameus has 4 established locations (Breda 2x, Tilburg, Roosendaal). All are included.

NOTE: This study is conducted both by Tilburg University (Department Tranzo) and Trimbos-institute (Department of Reintegration and Community Care) as primary organizations. The PI is also affiliated with both.

NOTE. The aimed sample size at t0 is N=120 in the RC condition. So 120 partakers of RCs will be matched with members from the PPG.

Eligibility Criteria:
Inclusion Criteria:

* For RC group: needs to attend one of the four participating RCs regularly, at least more than once.
* Needs to experience severe mental illness/psychological vulnerabilities (both self-reported or officially diagnosed).
* Needs to master the Dutch language to sufficient extent to understand the surveys.
* Is 18 years or older.

Exclusion Criteria:

* For the RC group: does not attend one of the four participating RCs regularly.
* Does not experience severe mental illness/psychological vulnerabilities.
* Does not master the Dutch language to a sufficient extent.
* Is younger than 18 years old.
* For the control group (PPG): attends an RC regularly, but not one of the four participating RCs. If an existing PPG member attends one of the four participating RCs regularly, they are allocated to the RC group.