Redefining mental health services: the power of co-production and self-guided recovery

Talk like a social and health psychologist

CHIME framework¹ — a tool used to aid self-recovery programmes focusing on connection, hope, identity, meaning and empowerment

Custodial — daily living support services for individuals, such as cooking, cleaning and personal hygiene support

Implementation science — the study of the methods and strategies that are used to facilitate the uptake of new evidence-based practices

Lived experience — personal experience gained through direct, first-hand involvement

Programme evaluation — a method used to measure and assess the impacts of a new programme, intervention or practice

Recovery College — a self-directed educational programme that supports traditional mental health treatment

Qualitative data — information that cannot be easily counted or measured and records the quality of something rather than the quantity

Quantitative data — information that can be easily counted or measured and records a numerical value or quantity

For a long time, the stigma surrounding mental health has made things difficult for individuals facing mental illness. Those affected are often misunderstood and may feel pressured to hide their struggles. Conditions like depression and anxiety can intensify these challenges, sometimes leading to self-isolating behaviours.

Thankfully, attitudes toward mental health have become more accepting and supportive in recent years. Along with these shifting attitudes, mental health support and services have also begun to change.

At Ontario Shores Centre for Mental Health Sciences (Ontario Shores) in Canada, Dr Simone Arbour has been developing Recovery College programmes and self-directed courses for people looking to improve their mental health and wellness.

What are Recovery Colleges?

Recovery Colleges (RCs) are built around self-recovery and self-driven care, where individuals can choose their own path to getting better. “Mental health services in Canada and abroad are moving away from a custodial model of care to one that positions the service user in the driver’s seat,” says Simone. “RCs are instrumental in this and have transformed the mental health care landscape.”

Instead of waiting months, or even years, for a mental health diagnosis and then following a treatment plan assigned by a medical professional, RCs allow patients to dictate their own recovery.

“The educational courses offered in RCs are co-produced by service users, who have lived experience of mental health challenges, and staff, who have professional experience,” says Simone. “The courses are constantly being redeveloped to ensure they are current, relevant and addressing the education and support needs of the community.”

RCs are places of learning, offering courses on topics that enhance health and well-being. These courses cover a variety of topics, including coping with depression, accepting illness and identifying unhealthy relationships. They also include arts-based courses, such as yoga and creative writing.

“RCs are designed to enhance an individual’s sense of connection, hope, identity, meaning and empowerment,” says Simone. These five components all contribute to a person’s recovery, as set out within the CHIME framework, which underlies the structure and content of RCs.

“RCs are designed to lessen the shame and stigma of mental illness,” says Simone. “A person’s sense of connection, hope, identity, meaning and empowerment can be influenced regardless of whether or not they have a mental illness or diagnosis. In addition, anyone can support this process, not just professionals. Therefore, while clinical recovery requires a medical diagnosis and professional support, personal recovery does not.”

Recovery Colleges at university

Traditionally, RCs have been established in hospitals and mental health community services. However, in 2020, a local university contacted Simone and her team at Ontario Shores to ask about offering RC courses in post-secondary education environments.

“Some of the students were living away from home for the first time and were finding the transition to this independence difficult,” explains Simone. “It should also be noted that the Covid-19 pandemic had just hit, making social connection even more of a challenge.”

The Ontario Shores team adapted the programme to suit a post-secondary education setting, and there are now over ten RCs set up in different colleges and universities across the province of Ontario.

“These RCs have a core group of courses for all students, but also specialised courses for specific student groups,” says Simone. Core courses include cooking, time management and studying tips, while specialised courses focus on international, first-year or LGBTQ+ students.

Measuring the impact of Recovery Colleges

“To examine the impact, we ask students to report how they felt before and after attending an RC, and then we compare these scores to see if they are statistically different,” explains Simone. “We have found significant improvements in self-reported recovery after attending the RC at Ontario Shores, and we have seen significant improvements to self-reported well-being, connection and self-esteem.”

To enrich this quantitative data, Simone and her team also ask open-ended questions to collect qualitative data. “For example, we ask what the students took away from their experience in the RC,” says Simone. “They told us that they feel less isolated, have learned from others and now have tools to help them in their recovery journey.”

What’s next?

Simone believes that RCs could help various specific populations and groups of people. “At the moment, we are developing an RC for individuals who are experiencing gender-based violence,” she says. “This RC will bring survivors and service providers together to learn and share, minimise feelings of shame, and make it easier to seek help.” Simone and her team are also working with students aged 12-18 to develop a recovery high school that will target young people who are waiting for mental health services.

While poor mental health can leave us feeling powerless and vulnerable, innovative services, such as RCs, can help us regain confidence and build self-esteem. As new RCs continue to be developed, this empowering form of self-directed recovery will become available to more and more people.

¹Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011 Dec;199(6):445-52. doi: 10.1192/bjp.bp.110.083733. PMID: 22130746.

Dr Simone Arbour
Research Scientist, Ontario Shores Centre for Mental Health Sciences, Canada

Field of research: Social and health psychology

Research project: Developing, implementing and measuring the impact of self-directed mental health Recovery Colleges

Funder: The Marinucci Family Foundation

About social and health psychology

Social and health psychologists study how psychological, social and biological factors influence physical and mental health. They look at the bigger picture to diagnose problems and improve their patients’ quality of life, and they must have brilliant people skills and a deep love of helping others.