Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries:a cross-sectional survey

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;

Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries: a cross-sectional survey

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<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. // Funding: National Institute for Health and Care Research

Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries: a cross-sectional survey.

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<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. FUNDING: National Institute for Health and Care Research

Organisational and student characteristics, fidelity, funding models, and unit costs of recovery colleges in 28 countries:a cross-sectional survey

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. Funding: National Institute for Health and Care Research.</p

The importance of helpful help in mental health crises : Experiences, stories, and contexts – A qualitative exploration

The main aim of this thesis was to explore experiences of helpful help in mental health crises within the context of crisis resolution teams (CRTs). Helpful help has been explored from three different perspectives: 1) service users, 2) carers, and 3) CRT clinicians. These perspectives are represented through three different sub-studies in this thesis. The study included a strategic sample of participants recruited from eight different health trusts, geographically covering large parts of Norway. Individual interviews with 14 service users and 12 carers as well as eight focus group interviews with a total of 50 clinicians were conducted. All interviews were conducted locally. The thesis has an explorative and troubling approach to truth and how knowledge can be created. My initial assumptions and understandings of truth and knowledge and how these are entwined with contexts, participants, and the researcher have been subject to continuous questioning, troubling, and development. These processes are understood as important parts of the knowledge that emanates from this project and are made transparent and reflected upon throughout the thesis as significant parts of its overall framework. A competence group consisting of people with diverse experiences as service-users, carers, and/or clinicians has contributed to the processes of exploring, troubling, and creating knowledge. The first article of this thesis explores service users’ experiences of helpful help in a mental health crisis. A hermeneutic phenomenological approach was used to analyze data into common themes across the dataset. The article suggests that experiences of mental health crises and helpful help are closely entwined. Mental health crises are experienced as devastating and multilayered events affecting the practical sides of life, sense of having worth, and sense of safety. Important issues relating to help that were emphasized by the participants were practical support and help with daily structure, establishing a foundation of safety, and strengthening the sense of self. The article discusses how these different issues of help are connected, suggesting that practical help plays an important role in supporting self-worth and the sense of safety. However, practical and structural issues were rarely addressed by CRTs. The article suggests the need for a broadened and social contextual-oriented perspective on mental health crises as important in developing practices that are perceived as more helpful. The second article explores carers’ experiences of helpful help. Data were analyzed using a narrative approach, focusing on emplotment. The configuration of data elements into coherent stories, using a personal plot as an organizing structure, revealed that seemingly thematically similar experiences have a highly personal imprint. Though experiences of burden and loss were common, these experiences were embedded within the personal history and context of the carer. The article discusses how understanding a carer’s individual experiences and needs in a contextual, storied manner can reveal information that is crucial to the collaboration of help that is perceived as helpful within a home-based approach to mental health crises. The third article explores discourses through which CRT clinicians understand and talk about helpful help. Data were analyzed using a discursive psychological approach. Two broad discourses were identified: helpful help as something “made,” with CRT workers as creators of collaborative and innovative practices, and helpful help as something “given,” with the CRT workers as representatives of a predefined specialist mental health service culture. The article discusses how the contradictions between these discourses reflect the diverse rationale for the development of CRTs and the possible tensions and pressures under which CRT work is conducted. In this overall context, the article also critically examines the tensions between the discourse of constructing new practices and existing practices constituted by the more traditional discourse in the specialist mental health services. Based on an overall discussion and reflection combining the three sub-studies, this thesis speaks to the necessity of introducing more person-in-context-oriented approaches in the understandings and practices of helpful help in mental health crises. There appears to be a gap between service users’ and carers’ desire for more contextually and practically oriented help and how help is talked about and acted out from the professional side. This thesis calls for further research on possible causes for this divide

There are three of us: parents’ experiences of the importance of teacher-student relationships and parental involvement in upper secondary school

The aim of this study was to obtain parents’ perspectives on the development and importance of teacher-student relationships (TSR) and parental involvement in upper secondary school. The study had a qualitative approach where 14 parents of upper secondary school students were interviewed. The data were analysed via a thematic analysis and organized into three main themes: (1) ‘The multitalented teacher’: mastering school subjects and personal relationships. (2) ‘Parents are responsible’: to support and guide students in teacher-student relationships. (3) ‘Between childhood and adulthood’: students must gradually take on more responsibility. The findings demonstrate that home and school are pivotal contexts in the lives of upper secondary students, and contribute to the development of a tripartite relationship between teacher, student, and parent (TSPR). Parental involvement is described as crucial, especially for students at risk. The study calls for awareness of how positive TSPR in upper secondary school can be developed

Performing Wild Time Workshopping Friendship as Critical Autoethnographic Paraversity Method

The focus of this autoethnographic paper is on its authors’ experiences of running a conference workshop on Friendship as Method in Paraversity scholarship development. Using the workshop sequence as a framework and context for the paper enables a developing focus on a key emerging analytic issue. This is the tensions around the conception, use and management of time between the Paraversity and the corporate academy. The authors show how friendship-based relations can be crucial for personal and academic thriving in promoting critical sensibilities and reflexivity. They argue, however, that, because it is normally associated with ineffective and unproductive time use, friendship is neither sufficiently encouraged nor taken seriously as a methodological topic in the corporate academy. Moreover, the corporate management of time and relations can inhibit the friendship-mediated development of critical and creative academics, the expansion and exploration of knowledge, and creative ways of generating knowledge

There are three of us: parents’ experiences of the importance of teacher-student relationships and parental involvement in upper secondary school

This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.The aim of this study was to obtain parents’ perspectives on the development and importance of teacher-student relationships (TSR) and parental involvement in upper secondary school. The study had a qualitative approach where 14 parents of upper secondary school students were interviewed. The data were analysed via a thematic analysis and organized into three main themes: (1) ‘The multitalented teacher’: mastering school subjects and personal relationships. (2) ‘Parents are responsible’: to support and guide students in teacher-student relationships. (3) ‘Between childhood and adulthood’: students must gradually take on more responsibility. The findings demonstrate that home and school are pivotal contexts in the lives of upper secondary students, and contribute to the development of a tripartite relationship between teacher, student, and parent (TSPR). Parental involvement is described as crucial, especially for students at risk. The study calls for awareness of how positive TSPR in upper secondary school can be developed.There are three of us: parents’ experiences of the importance of teacher-student relationships and parental involvement in upper secondary schoolpublishedVersio

Powerless yet powerful: The duality of everyday life of partners of persons with gambling problems

This study explores how partners of persons with gambling problems experience the family’s everyday life, focusing on family relations and parenting. Problem gambling creates a serious impact on household finances, social life and health, emotional and relational issues. Between 6 and 10 persons are directly affected by a person’s gambling problems. Despite this, research exploring how daily life and relations in the family is affected is scarce. A qualitative method was used to acquire a deeper understanding of partners’ experiences of everyday life, relations and parenting. In-depth interviews were carried out with nine female partners of problem gamblers. All nine women had been responsible for minor children. A thematic analysis was used to systemize the participants’ experiences. The results determined how living with a partner with a gambling problem is a lonely project. Partners of problem gamblers take on a lot of responsibility for daily life activities, household finances and parenting but experience little support from their partner. A general lack of knowledge and recognition of gambling as a problem, increases the loneliness, shame and burden. Despite gambling having a tremendous impact on daily life and relations, families receive little support. Taking over responsibility and becoming the one in charge, can be understood as ways of reclaiming dignity and gaining power albeit within limits. This duality needs to be considered when providing support to families

"Det går på en måte aldri over" : en kvalitativ undersøkelse av hverdagserfaringer og levekår i familier med spilleproblemer

Denne kvalitative undersøkelsen av hverdagserfaringer og levekår i familier med spilleproblemer er finansiert gjennom Handlingsplan mot spilleproblemer (2016-2018). Rapporten er basert på individuelle intervjuer med 12 pårørende (9 voksne og 3 unge) som hadde erfaring med spilleproblemer i familien. Informantene ble rekruttert gjennom organisasjonen Spillavhengighet Norge og Blå Kors. Også organisasjonen Voksne for barn informerte om studien på sine hjemmesider. Studien er ledet av FOU-avdelingen, psykisk helsevern ved Akershus Universitetetssykehus (Ahus), med Høgskolen i Sørøst-Norge som samarbeidspar