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Objective: Recovery Colleges support recovery for adults with mental health problems, through coproduction and education principles. This study aimed to determine whether students at three Recovery Colleges in England were representative of mental health service users. Methods: Gender, age, ethnicity, diagnosis, involuntary detention, and inpatient admission were extracted from clinical records. Data for all service user students enrolled, and those who had attended 70% of a Recovery College course were compared to mental health services caseloads, using chi-square goodness-of-fit tests. Results: Clinical records were identified for 1,788 students. Significant differences were identified for gender, age, and diagnosis (p <.001). In some Colleges, more students had recent inpatient admissions or involuntary detentions. Conclusions and Implications for Practice: Service user students were largely representative of mental health service users, although some groups were underrepresented. Further research is needed to understand why, so that Recovery Colleges can continue to address inequalities. Impact and Implications: This is the first multisite investigation into the characteristics of Recovery College students. It found that students are largely representative of people using mental health services, at different stages of their recovery. However, Colleges and mental health services could work on improving access for male, younger and older service users, and individuals with certain mental health diagnoses. [ABSTRACT FROM AUTHOR]

Objective: The current article describes efforts to develop and test a measure of recovery-oriented inpatient care. Method: The Recovery-oriented Acute INpatient (RAIN) scale was based on prior literature and current Veterans Health Administration (VHA) policy and resources and further revised based on data collection from 34 VHA acute inpatient units. Results: A final scale of 23, behaviorally anchored items demonstrated a four-factor structure including the following factors: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. While several items require additional revision to address psychometric concerns, the scale demonstrated adequate model fit and was consistent with prior literature on recovery-oriented inpatient care. Conclusions and Implementations for Practice: The RAIN scale represents an important tool for future implementation and empirical study of recovery-oriented inpatient care. Impact and Implications: This study focused on developing a scale to measure recovery-oriented inpatient mental health care. The study found a 23-item scale matched prior literature and included four general areas of recovery-oriented inpatient care: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. This scale can be used to improve the recovery orientation of inpatient programming. [ABSTRACT FROM AUTHOR]

Objective: Trauma experienced by individuals with serious mental illnesses extends beyond physical and sexual abuse. This is among the first studies to examine verbal violence, both spoken and written words, experienced by individuals with serious mental illnesses. Method: Fifty individuals diagnosed with a schizophrenia-spectrum, bipolar, or major depressive disorder were recruited from community-based mental health agencies and reported on their experiences with 8 types of verbal violence identified in the literature, or related written comments, including: belittling, insulting, name-calling, teasing/ embarrassing, threatening, cursing, or yelling. They also reported on the frequency of such events and the perpetrators. Results: 82% of participants reported at least 1 type of verbal violence in their lifetime and 66% reported an incident in the past year. The most common experiences were being called names, belittled, and insulted, teased, or embarrassed in front of others. Top perpetrators were friends and parents. Conclusions and Implications for Practice: Verbal violence is a common experience with potentially devastating effects on mental health and well-being, sense of safety, and recovery and community participation among adults with serious mental illnesses. It is plausible that such comments deserve being recognized as "violence" on par with physical and sexual assaults, although further research would be useful to expand our knowledge about their effects on health, wellness, and community inclusion. New interventions that prevent, lessen, and eliminate such violence, may also be advisable. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to assess the impact of a mental illness self-management intervention, called Wellness Recovery Action Planning (WRAP), on the use of and need for mental health services over time compared with nutrition and wellness education. Method: Participants were recruited from outpatient community mental health settings in Chicago, Illinois. Using a single-blind, randomized controlled trial design, 143 individuals were assigned to WRAP or to a nutrition education course and assessed at baseline and at 2-month and 8-month follow-up. The WRAP intervention was delivered by peers in recovery from serious mental illness who were certified WRAP educators over nine weekly sessions lasting 2.5 hrs. The nutrition education curriculum was taught by trained non-peer educators using the same schedule. Mixed-effects random regression analysis tested for differences between the two interventions in (a) self-reported use of 19 clinical, rehabilitation, peer, emergent, and ancillary services; and (b) self-reported need for these services. Results: Results of mixed-effects random regression analysis indicated that, compared with controls, WRAP participants reported significantly greater reduction over time in service utilization (total, individual, and group), and service need (total and group services). Participants in both interventions improved significantly over time in symptoms and recovery outcomes. Discussion: Training in mental illness self-management reduced the self-reported need for and use of formal mental health services over time. This confirms the importance of WRAP in an era of dwindling behavioral health service availability and access. [ABSTRACT FROM AUTHOR]

Objective: Most research on the Illness Management and Recovery (IMR) program for people with severe mental illnesses has focused on individuals with stable symptoms living in the community, with less attention to persons being treated in an inpatient setting. We evaluated the feasibility and effects of an IMR program adapted for individuals with schizophrenia who were awaiting discharge into the community. Method: A randomized controlled trial was conducted at 2 hospitals in Taiwan to compare the adapted IMR program with treatment as usual (TAU). Ninety-seven individuals with schizophrenia were randomized to the adapted IMR program or TAU. Four outcome indicators including illness-management knowledge, attitudes toward medication, insight, and symptoms were assessed at baseline, posttreatment, and at a 1-month follow-up following discharge from the hospital. Results: Participants in the adapted IMR group showed significantly greater improvements at posttreatment and 1-month follow-up in illness-management knowledge, attitudes toward medication, insight, and negative symptoms on the Brief Psychiatric Rating Scale (BPRS) than individuals in the TAU group. There were no significant differences between the 2 groups on other subscales of the BPRS. Conclusions and Implications for Practice: This is the first controlled evaluation of a version of the IMR program in an East Asian culture, and the first to evaluate it in an acute care inpatient setting. Our findings support the feasibility and potential benefits of implementing an adapted IMR program, focused on the prevention of relapses and rehospitalizations, during the discharge period of an inpatient treatment stay to prepare individuals to reenter the community. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to refine and test the psychometric properties of a scale to measure provider attitudes about recovery. Method: This was a secondary data analysis that combined survey data from 1,128 mental health providers from 3 state hospitals, 6 community mental health centers, and 1 Department of Veterans Affairs (VA) medical center. Rasch analyses were used to examine item-level functioning to reduce the scale to a briefer, unidimensional construct. Convergent validity was assessed through correlations with related measures. Results: The Provider Expectations for Recovery Scale had strong internal consistency, was related to education and setting in expected ways, and was associated with lower levels of burnout and higher levels of job satisfaction. Conclusions and Implications for Practice: A 10-item scale of Provider Expectations for Recovery appears to be a useful tool to measure an important construct in recovery-oriented care. The process of refining the measure also highlights potential factors in how providers view recovery. [ABSTRACT FROM AUTHOR]

Objective: This paper examines the types of goals being set by individuals in the context of Australian mental health services and whether goal type differs across the stages of recovery. Methods: Goal records of 144 individuals accessing services were reviewed to examine goal content, ratio of approach and avoidance oriented goals and changes across stages of psychological recovery. Results: Individuals further along in their recovery set significantly more approach goals and types of goals set appeared to reflect broader life roles. Conclusions and Implications for Practice: Setting approach goals and goals that reflect broader life roles tends to support the definition of psychological recovery as being "the movement towards" greater meaning and enhanced sense of self. [ABSTRACT FROM AUTHOR]

Objective: The promotion of recovery and quality of life is a major focus of national and local mental health system transformation efforts. There has been simultaneous interest in enhancing community participation as a facilitator of recovery. This study examines the community participation experiences of emerging adults and mature adults with serious mental illnesses and the relationship between various types of participation and recovery, quality of life, and meaning of life. Methods: Baseline data from the Consumer-Operated Service Program multisite study were utilized. The sample was recruited from traditional mental health services and consisted of 233 emerging adults and 1,594 mature adults. Ten areas of participation were examined: parenting, employment, volunteering, college student, group membership, civic engagement, peer support, friendships, intimate relationships, and engagement in religious/spiritual activities. Results: Emerging and mature adults differed in developmentally appropriate ways. Emerging adults and those who participated more had higher scores on the recovery, quality of life and meaning of life measures. Conclusions and Implications for Practice: The higher scores on the dependent variables may be explained by younger adults having greater hope and higher expectations that are typical for those at that stage of life and that living longer with a serious mental illness and being exposed longer to the mental health system may dampen hope. Participation in general, and specific areas of participation, were predictive of recovery-oriented outcomes. These results should inspire future developmentally-oriented research examining factors that facilitate recovery and provide direction to providers about participation areas that may be most beneficial in facilitating recovery. [ABSTRACT FROM AUTHOR]

Objective: The promotion of recovery and quality of life is a major focus of national and local mental health system transformation efforts. There has been simultaneous interest in enhancing community participation as a facilitator of recovery. This study examines the community participation experiences of emerging adults and mature adults with serious mental illnesses and the relationship between various types of participation and recovery, quality of life, and meaning of life. Methods: Baseline data from the Consumer-Operated Service Program multisite study were utilized. The sample was recruited from traditional mental health services and consisted of 233 emerging adults and 1,594 mature adults. Ten areas of participation were examined: parenting, employment, volunteering, college student, group membership, civic engagement, peer support, friendships, intimate relationships, and engagement in religious/spiritual activities. Results: Emerging and mature adults differed in developmentally appropriate ways. Emerging adults and those who participated more had higher scores on the recovery, quality of life and meaning of life measures. Conclusions and Implications for Practice: The higher scores on the dependent variables may be explained by younger adults having greater hope and higher expectations that are typical for those at that stage of life and that living longer with a serious mental illness and being exposed longer to the mental health system may dampen hope. Participation in general, and specific areas of participation, were predictive of recovery-oriented outcomes. These results should inspire future developmentally-oriented research examining factors that facilitate recovery and provide direction to providers about participation areas that may be most beneficial in facilitating recovery. [ABSTRACT FROM AUTHOR]