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BackgroundRecovery Colleges (RCs) support the recovery of individuals who have mental health issues, using the principles of coproduction and adult learning. There has been little international research on RCs and none investigating costs, staffing, or fidelity to these and other principles. We aimed to characterise RCs internationally. MethodsWe conducted an observational study integrating two equivalent cross-sectional surveys, one conducted within England in 2021 and one in all other countries in 2022. We included all RCs meeting recovery orientation, coproduction and adult learning criteria. Managers completed a survey capturing organisational and student characteristics, fidelity and budget. RCs were grouped by country and continent to allow for regression models exploring continental differences in fidelity.OutcomesWe identified 221 RCs operating across 28 countries, spanning five continents. Overall, 174 (79%) RCs participated in the survey. Most scored high on fidelity. Compared with England, RCs in Asia scored lower on overall fidelity, ‘coproduction’ and ‘tailored to the student’. Annual budgets in the 133 (60%) colleges providing economic data were €0-2,550,000, varying extensively within and between continents. Among the RCs who provided data, annual budgets totalled €30m, providing 19,864 courses for 55,161 students. InterpretationRCs exist in many countries. There is an international consensus on key operating principles, especially equality and a commitment to recovery, and most RCs achieve moderate to high fidelity, irrespective of the income band of their country. Cultural differences need to be considered in assessing coproduction and approaches to individualising support.

Background: Mental health recovery narratives are an active ingredient of recovery-oriented interventions such as peer support. Recovery narratives can create connection and hope, but there is limited\ud evidence on the predictors of impact.\ud Aims: The aim of this study was to identify characteristics of the narrator, narrative content and participant which predict the short-term impact of recovery narratives on participants.\ud Method: Independent studies were conducted in an experimental (n ¼ 40) and a clinical setting\ud (n ¼ 13). In both studies, participants with mental health problems received recorded recovery narratives and rated impact on hopefulness and connection. Predictive characteristics were identified using\ud multi-level modelling.\ud Results: The experimental study found that narratives portraying a narrator as living well with mental\ud health problems that is intermediate between no and full recovery, generated higher self-rated levels\ud of hopefulness. Participants from ethnic minority backgrounds had lower levels of connection with\ud narrators compared to participants from a white background, potentially due to reduced visibility of a\ud narrator’s diversity characteristics.\ud Conclusions: Narratives describing partial but not complete recovery and matching on ethnicity may\ud lead to a higher impact. Having access to narratives portraying a range of narrator characteristics to\ud maximise the possibility of a beneficial impact on connection and hopefulness.

There has been a call for a paradigm shift in mental health to be more recovery-oriented and include service users in the development and delivery of services. Although co-production has been linked with positive outcomes, more work is needed to understand this approach in Canada. The current study assessed the outcomes of a co-production initiative for service design and delivery. The data yielded positive outcomes—both for facilitators and group participants—in two broad areas: related to personal recovery and positive attitudes toward the organization. This study provides support for co-production in mental health programming and further elucidation of this approach for mental healthcare settings in Canada.

The Recovery College at Ontario Shores provides service users who have mental health challenges with courses, which they choose, to learn about recovery, mental health, treatment options, leisure, and fun. College components designed to enhance recovery also include peer support and access to the library to enhance individualized learning.

In a field traditionally fraught with pessimistic expectations and lower client satisfaction, recovery in mental health care is a beacon of light guiding practitioners and clients alike toward a more hopeful, optimistic future where possibility exists. An important component of the recovery model is the inclusion of service users in the management of their illness, developing wellness, and treatment planning. However, recovery in mental health is a relatively young theoretical and philosophical approach: efforts to shift from philosophy and theory to actual system change within the Canadian mental healthcare system have proven challenging. In our experience implementing a recovery-oriented program to support service users to co-design and co-deliver wellness groups, we learned about our hospital’s readiness for transformational system change and the specific needs with regard to this type of change. The purpose of this article is to describe our process, and share our successes and obstacles in order to inspire and support others who are interested in attempting to incorporate recovery-oriented practices into their settings.

Substance use disorder is a concerning health issue, affecting military and civilians alike. Due to exceptional workplace demands and a unique military culture, it is important to explore whether military members respond to addiction treatment in the same manner as their civilian counterparts. The present study compared individual characteristics and addiction treatment outcomes between Canadian military members and civilians attending the same residential program. Results revealed that both groups experienced comparable outcomes at 6 months follow-up. Military members reported significantly higher levels of some aspects of quality of life, compared to civilians. Results support the notion that an integrated, nonmilitary treatment program can be appropriate for military members seeking addiction treatment.

Objective:\ud \ud Mental health recovery narratives are often shared in peer support work and antistigma campaigns. Internet technology provides access to an almost unlimited number of narratives, and yet little is known about how they affect recipients. The aim of this study was to develop a conceptual framework characterizing the impact of recovery narratives on recipients.\ud Method:\ud \ud A systematic review of evidence about the impact of mental health recovery narratives was conducted. Searches used electronic databases (n = 9), reference tracking, hand-searching of selected journals (n = 2), grey literature searching, and expert consultation (n = 7). A conceptual framework was generated through a thematic analysis of included articles, augmented by consultation with a Lived Experience Advisory Panel.\ud Results:\ud \ud In total, 8137 articles were screened. Five articles were included. Forms of impact were connectedness, understanding of recovery, reduction in stigma, validation of personal experience, affective responses, and behavioural responses. Impact was moderated by characteristics of the recipient, context, and narrative. Increases in eating disorder behaviours were identified as a harmful response specific to recipients with eating disorders.\ud Conclusions:\ud \ud Mental health recovery narratives can promote recovery. Recovery narratives might be useful for clients with limited access to peers and in online interventions targeted at reducing social isolation in rural or remote locations, but support is needed for the processing of the strong emotions that can arise. Caution is needed for use with specific clinical populations. Protocol registration: Prospero-CRD42018090923.

This study quantified the benefits of inpatient addiction treatment by examining its impact on work-related variables. Participants were 154 employed adults who completed addiction treatment and measures of absenteeism, tardiness, and productivity at pretreatment and 6-months follow-up. The impact of substance of choice and employer involvement was examined. Treatment produced significant improvements in all three variables. Furthermore, even though workplace variables differed significantly based on substance of choice and employer involvement, participants reported comparable outcomes at follow-up. Based on these results, a conservative cost-benefit analysis of inpatient treatment is discussed.

Studies have shown that eating disorders and substance use disorders often co-occur and share common clinical and biological substrates. Given the high prevalence of co-occurring eating and substance use disorders, it is important to explore the impact of the dual-diagnosis on treatment outcomes. The present study compared individuals with an eating disorder only (ED) to those with a comorbid eating and substance use disorder (ED-SUD) on several factors related to 6-month post-treatment outcomes in eating attitudes and behavior and quality of life. Results show that both ED and ED-SUD clients experience significant improvements in self-reported eating disorder symptoms and concerns, as well as quality of life functioning. There were no significant differences in outcomes between ED and ED-SUD clients, which suggests that the two conditions can be successfully treated together.

This study attempts to identify factors associated with greater aftercare participation for 367 adults who completed abstinence-based residential addiction treatment between 2004 and 2007 at Bellwood Health Services in Toronto, Canada. Pre-treatment substance use, number of days spent in residential treatment, motivation, treatment satisfaction, and demographics were used to determine which characteristics predicted greater aftercare participation. The duration of residential treatment and treatment satisfaction emerged as significant predictors of aftercare attendance. Regular aftercare attendance was associated with lower levels of substance use at 6-month follow-up. Results suggest that a longer duration of residential treatment can influence continuing care engagement and highlight the importance of initial treatment retention for long-term recovery.

The present study examined the impact of an in-patient addiction treatment program and whether client-related treatment outcomes were moderated by addiction type: (1) alcohol only; (2) cocaine only or with alcohol; (3) cocaine with other substances; and (4) prescription drugs and/or cannabis. Clients completed self-reports of their substance use and quality of life during their first week in treatment and at 6-months post-discharge. Pre-treatment motivation and post-treatment aftercare attendance were also assessed. Overall, a positive impact of the addiction treatment programme was noted as clients reported a significant reduction in substance use and improvement in quality of life. Results also demonstrated that drug of choice impacted recovery status such that compared with cocaine poly substance clients, alcohol clients obtained significantly higher scores on quality of life measures at both pre- and 6-months post-treatment. However, cocaine poly substance clients were also significantly younger than ...