A user-developed, user run recovery programme for people with severe mental illness: A randomised control trial

Abstract

We examined, over a two-year period, the impact of a user-developed and user-run recovery programme (Toward Recovery, Empowerment and Experiential Expertise – TREE) on outcomes in individuals with severe mental illness, as add-on to care as usual. A randomised wait-list controlled design of TREE added to care as usual (CAU) (n = 80), versus CAU only (n = 83), was implemented in patients with severe mental illness. Follow-up was at 12 and at 24 months after inclusion. Primary outcome measures were empowerment, mental health confidence and loneliness. Secondary outcomes were quality of life, self-reported symptoms, care needs, service use and community outcomes (likelihood institutional residence and paid employment). TREE was associated with more mental health confidence (effect size for each year in TREE: 0.058, p = 0.043), less care needs (effect size for each year in TREE: –0.088, p = 0.002), less self-reported symptoms (effect size for each year in TREE: –0.054, p = 0.040) and less likelihood of institutional residence (risk ratio with each year in TREE: 0.79, p = 0.027). User-developed and user-run recovery programmes may bring about small but reliable changes in recovery and community outcome after two years. More research is required to examine how such programmes can become more successful within the context of disability-focused mental health services.