Development and evaluation of a mental health recovery priority measure for cross-cultural research: global INSPIRE

Abstract

Purpose: This study developed and evaluated a new personal recovery scale—Global INSPIRE—in English and Japanese, and compared responses between Japan and the UK. Personal recovery—living a satisfying and meaningful life despite mental health challenges—has gained attention in mental health. The widely-used CHIME framework identifies five recovery processes: Connectedness, Hope, Identity, Meaning, and Empowerment. Full INSPIRE evaluates whether service users feel supported in each CHIME process. However, emerging cross-cultural evidence indicates differences in the priority placed on each CHIME domain. No tool exists to assess recovery priorities, hindering cross-cultural research. Methods: The 20-item self-completed Global INSPIRE was adapted from the Full INSPIRE to assess recovery priorities of both service users and non-service users. Participants in the UK (n = 512) and Japan (n = 507) completed the Global INSPIRE at baseline and two-week follow-up. Psychometric properties were evaluated, including reliability, test-retest stability, and discriminant validity with two established recovery scales—CORE-10 and QPR-15. Cross-national differences in recovery priorities were also examined. Results: Both versions showed excellent reliability (α = 0.91 UK; 0.97 Japan), test-retest stability (4/5 processes UK, 5/5 Japan), and acceptable model fit (CFI = 0.80 UK; 0.85 Japan). Measurement invariance supported configural (CFI = 0.89) and metric invariance (CFI = 0.89) but not scalar invariance (CFI = 0.83). Discriminant validity was supported by weak correlations with CORE-10 and QPR-15. UK participants prioritised Hope, Meaning, and Empowerment, while Japanese participants prioritised Identity. Conclusion: Global INSPIRE is a reliable and culturally adaptable tool for assessing distinct recovery priorities. Future research should explore demographic differences and expand testing across diverse cultural contexts.