Mechanisms of change and participant outcomes in a Recovery Education Centre for individuals transitioning from homelessness: a qualitative evaluation.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Mental Health Services*; Ill-Housed Persons/*psychology ; Mental Disorders/*rehabilitation ; Patient Education as Topic/*methods; Adult ; Canada ; Female ; Ill-Housed Persons/statistics & numerical data ; Humans ; Male ; Middle Aged ; Poverty ; Program Evaluation ; Qualitative Research

Background: Recovery Education Centres (RECs) are increasingly implemented to support the process of recovery for individuals experiencing mental health challenges. However, the evidence on key REC mechanisms and outcomes, particularly for diverse subpopulations or service delivery contexts is scant. This study identified mechanisms and outcomes of an REC focused on adults with mental health challenges transitioning from homelessness.
Methods: Qualitative methods were used to explore in-depth the experiences of homeless and unstably housed participants experiencing mental health challenges in Toronto, Canada. Twenty service users participated in semi-structured interviews between July 2017 and June 2018, six to 14 months following REC enrollment. A realist informed interview guide explored participants' perspectives on key REC mechanisms and outcomes. Interviews were audio-recorded, transcribed verbatim and analyzed using inductive thematic analysis. Investigator triangulation and member checking processes enhanced analytical rigour.
Results: Participants perceived that program participation supported the process of recovery through several mechanisms: a judgment-free environment; supportive relationships, mutuality and role modelling; deconstruction of self-stigma; and reclaiming of one's power. Participants described several outcomes at the personal, interpersonal and social levels, including improvements in health and well-being; self-esteem, confidence and identity; sense of empowerment, control and personal responsibility; as well as improvements in interpersonal skills, pro-social behaviours and ability to self-advocate; and increased goal development and future orientation.
Conclusions: Findings suggest RECs can support the process of recovery among people transitioning from homelessness and can successfully support subpopulations experiencing mental health challenges and social disadvantage.

Community Ment Health J. 2005 Apr;41(2):141-58. (PMID: 15974495)
Psychiatr Serv. 2018 Dec 1;69(12):1222-1229. (PMID: 30220242)
Psychiatr Rehabil J. 2019 Jun;42(2):147-157. (PMID: 30730171)
Int J Soc Psychiatry. 2019 Sep;65(6):468-478. (PMID: 31250692)
World Psychiatry. 2009 Jun;8(2):75-81. (PMID: 19516923)
Psychiatr Serv. 2016 Jun 1;67(6):610-4. (PMID: 26876661)
Adm Policy Ment Health. 2008 Sep;35(5):357-69. (PMID: 18553131)
Br J Psychiatry. 2011 Dec;199(6):445-52. (PMID: 22130746)
BMJ Open. 2013 Sep 10;3(9):e003442. (PMID: 24022392)
BMJ Open. 2014 Mar 03;4(3):e004379. (PMID: 24589826)
BMJ Qual Improv Rep. 2015 Nov 11;4(1):. (PMID: 26734387)
Can J Psychiatry. 2019 Jun;64(6):405-414. (PMID: 30595039)
BMC Health Serv Res. 2017 Jul 11;17(Suppl 1):457. (PMID: 28722550)
Am Psychol. 2010 Oct;65(7):646-59. (PMID: 20873882)
World Psychiatry. 2019 Jun;18(2):141-142. (PMID: 31059628)
Psychiatr Serv. 2015 Jun;66(6):592-7. (PMID: 25686813)
Psychiatr Serv. 2012 Jan;63(1):10-2. (PMID: 22227753)
J Ment Health. 2018 Aug;27(4):359-366. (PMID: 29275749)
Psychiatr Rehabil J. 2011 Spring;34(4):321-3. (PMID: 21459749)

n/a Canada CAPMC CIHR

Keywords: Homelessness; Mechanisms; Outcomes; Recovery college; Recovery education

Date Created: 20200417 Date Completed: 20201002 Latest Revision: 20221207

20240628

PMC7161283

10.1186/s12889-020-08614-8

32295561