Research
Imroc has a long history of undertaking Recovery-focused research and evaluation, reviewing evidence and always basing our approach, practice, values and developments on relevant evidence. We take an inclusive approach in our definition of evidence. This means that we value evidence generated through the whole spectrum of research methodologies so long as studies are well explained, justified and reported (so that we can assess quality). Also, since we are frequently working in innovative ways that are in early stages of research, we take account of practice-based evidence: what people/services tell us about what works for them.
The value that we place on evidence is well demonstrated in our coproduction model which is based on ‘The Triangle that Moves Mountains’. This means that everything that we coproduce as a group of equally valued stakeholders with diverse expertise and experience, is informed by research, evaluation and case studies of best practice. (For an explanation of this approach see Repper, J. and Eve, J. (2022) Embedding coproduction in organisational culture and practice: a case study, Leadership in Health Services. ISSN: 1751-1879
We continually write up Imroc’s position on our approaches- including the evidence underpinning them, any evaluation/research that we have been engaged in and ongoing questions in our Briefing Papers. Since evidence, policies and practice evolve over time, the same topics may be revisited over time to reflect developments and reposition Imroc’s approach.
Imroc’s Research:
Imroc coproduced the first peer support training for PSWs employed in NHS services and based this on a review of research. Funding for the first cohorts of peer support was based on evaluation of this innovative approach (link to publications) which has significantly influenced the NHSE competency framework for peer support.
Imroc researchers have published several evaluations of Recovery Colleges.
Our research team have undertaken research into peer support, recovery focused practice and service development (link to PhDs and papers).
External Evaluation of Our Work:
Nottingham Trent University Department of Psychology was subcontracted by Imroc to evaluate the impact of their Live Well approach which was coproduced to support people with long term conditions in Primary Care through peer support workers. The NTU evaluation reported positive findings achieved over an 18 month period including a predicted 100% return on investment, and improvements in physical and psychological wellbeing for those supported (e033137.full.pdf (bmj.com))
Matter of focus - Imroc commissioned Matter of Focus to undertake an external evaluation of mental health peer support training (2022-23) and autism peer support training (2024-5). This has been helpful to inform continual improvement of the training and to demonstrate the strengths of the course and the views and experiences of students and tutors (Evaluating a peer support training programme by Imroc - Matter of Focus (matter-of-focus.com)
Imroc as a Co-Applicant in Recovery-Focused Research:
Imroc research staff are engaged in a number of Recovery-focused research national and international research projects as co-applicants. Our distinct contribution to research teams falls into three categories:
Lived Experience research expertise – the majority of Imroc’s research team bring lived experience of mental health challenges combined with experience of conducting and supporting lived experience-led research. We are able to support lived experience researchers; advise upon/supervise experiential and autoethnographic research methods; recognise and articulate the challenges for lived experience researchers working in a research team dominated by mental health professionals.
Recovery-focused expertise and knowledge – we bring extensive understanding of the meaning, complexity, facilitation and support of personal and social Recovery both as people using services and people providing, managing and evaluating services.
Widespread experience and expertise in Recovery-focused practice – since Imroc has longstanding experience of working nationally and internationally to support, facilitate and inform Recovery-focused practice we provide a strong sense of what is happening in practice in statutory and VCSE services. We provide a practice based sounding board for research teams and we can facilitate access to relevant services and individuals.
Recent Research Projects with Imroc as Co-Applicant:
NEON (2017-2023)
The NEON programme of research was led by and Mike Slade and Stef Rennick Egglestone at University of Nottingham and funded by developed a conceptual framework characterising recovery narratives which was based on a pre-registered review protocol. This was validated in interviews with people from under-researched groups, and then used to create the INCRESE instrument to characterise recovery narratives. The impact framework was developed into a change model through interviews with people from under-researched groups , and a causal change model for impact through connection was then experimentally developed. All the above work was integrated to develop the NEON Intervention, which was evaluated in three randomised controlled trials in England from 2020 to 2022, based on the published trial protocol. The NEON-O Trial for people with non-psychosis mental health problems involved 1,023 people from across England, and found that the NEON Intervention was both effective, leading to higher quality of life and improved meaning in life, and cost-effective, especially for people currently using mental health services. The NEON-C Trial involved 54 informal carers of people with mental health problems, and established that the NEON Intervention is acceptable and feasible for people providing informal support to others.
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Slade, M., Rennick-Egglestone, S., Elliott, R., Newby. C., Robinson, C., Gavan Sean-P., Paterson L., Ali, Y., Yeo, C., Glover, T., Pollock, C., Callard, F., Priebe, S., Thornicroft, G., Repper, J., Keppens, J., Smuk, M., Franklin, D., Walcott, D., Harrison, J., Smit, R., Robotham, D., Bradstreet, S., Gillard, S., Cuijpers, P., Farkas, M., Dror Ben Zeev., Davidson L., Kotera Y., Roe, J., Ng, F., Llewellyn-Beardsley, J., (2024) Effectiveness and cost-effectiveness of online recorded recovery narratives in improving quality of life for people with non-psychotic mental health problems: a pragmatic randomized controlled trial World Psychiatry 23:1: 101 -112
HOPE (2022-2026)
The HOPE project will develop and test community-based interventions to address the needs of people who are homeless and have serious mental health challenges (SMI). A total of £2,999,974 NIHR funding was awarded for the project to run in sites across Ethiopia, Ghana and Kenya from September 2022 to September 2026. The project will create a new partnership of researchers, policy makers, community members and people with lived experience of SMI and homelessness. It will work in a capital city (Addis Ababa) in Ethiopia, a regional city (Tamale) in Ghana, and a rural county (Makueni) in Kenya to understand the different approaches needed across varied settings.
The project will work in three phases: phase one will map existing contexts, lived experience, needs, priorities and opportunities through ethnography and surveys; phase two will co-produce and pilot intervention packages; phase three will test the intervention packages in specific geographic areas to reach 350 people experiencing homelessness and (SMI) per site. By the end of the project, researchers hope to have:
Developed evidence-supported interventions to improve the lives of people who are homeless and have SMI relevant for diverse settings in Africa.
Produced a manual on how to adapt and implement the programme in different settings.
Developed methods, ethical frameworks and the capacity of early career researchers and other stakeholders in Ethiopia, Ghana and Kenya to work in this area.
Built a strong collaboration of multi-sector partners to sustain future in-country work and longer-term high-quality research on this neglected topic.
Imroc is a co-applicant providing advice on the role and support for lived experience researchers and delivered peer support training in peer support, plus training for peer support trainers in each of the three countries involved.
UPSIDES
UPSIDES aimed to scale up peer support interventions for people with severe mental illness in high-, middle- and low-resource settings. An international community of practice for peer support including peer support workers, mental health researchers, and other relevant stakeholders in Europe, Africa and Asia was established to adapt peer support for local cultures. Using a mixed-methods approach, the impact of peer support was evaluated at the levels of patients and peer support workers (psychosocial and clinical outcomes), services (cost-effectiveness, return on investment), and implementation (adoption, sustainability, organisational change). Evidence of best practice was shared with local, national and international stakeholders ensuring that the peer support interventions reach new places and continue to be used successfully.
Matter of Focus
Imroc co-led the development of the peer support training and training for trainers package and co-delivered the training for peer support trainers.
Imroc commissioned Matter of Focus to undertake an external evaluation of mental health peer support training (2022-23) and autism peer support training (2024-5).
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Puschner B, Repper J, Mahlke C, Nixdorf R, Basangwa D, Nakku J, Ryan G, Baillie D, Shamba D, Ramesh M, Moran G, Lachmann M, Kalha J, Pathare S, Müller-Stierlin A, Slade M (2019). Using Peer Support in Developing Empowering Mental Health Services (UPSIDES): Background, Rationale and Methodology. Ann Glob Health, 85(1), 53, 1–10. doi: 10.5334/aogh.2435
Charles A, Thompson D, Nixdorf R, Ryan G, Shamba D, Kalha J, Moran G, Hiltensperger R, Mahlke C, Puschner B, Repper J, Slade M, Mpango R (2020). A typology of modifications to peer support work for adults with mental health problems: systematic review, Br J Psychiatry, 216(6), 301-7. doi: 10.1192/bjp.2019.264
Ibrahim N, Thompson D, Nixdorf R, Kalha J, Mpango R, Moran G, Mueller-Stierlin A, Ryan G, Mahlke C, Shamba D, Puschner B, Repper J, Slade M (2020). A systematic review of influences on implementation of peer support work for adults with mental health problems. Soc Psychiatr Psychiatr Epidemiol, 55(3):285-93. doi: 10.1007/s00127-019-01739-1
Charles A, Nixdorf R, Ibrahim N, Gai Meir L, Mpango R, Ngakongwa F, Nudds H, Pathare S, Ryan G, Repper J, Wharrad H, Wolf P, Slade M, Mahlke C (2021) Initial training for mental health peer support workers: international Delphi Consultation, JMIR Mental Health, 5, e25528. doi: 10.2196/25528
Mahlke C., Nixdorf R., Repper J., Charles A., Slade M., Ryan G., Hall C., Bailie D., Hiltensperger R., Müller-Stierlin A., Nakku J., Mpango R., Shamba D., Ramesh M., Garber-Epstein P., Moran GS., Kalha J., Korde P., Puschner B., and UPSIDES Peer Support Trainers (2020). UPSIDES Peer Support Training Manual and Workbook: field version
Nakku J., Ryan GK., Aslam R., Baillie D., Ben-Dor IA., Charles A., Gai Meir L., Garber-Epstein P., Grazyman A., Grundman SH., Hall C., Haun M., Heuer I., Hiltensperger R., Kalha J., Korde P., Krishnamoorthy S., Kulkarni A., Kwebiiha E., Lohner M., Mahlke C., Mlay A., Moran GS., Mpango R., Mtei R., Müller-Stierlin A., Mwanga S., Ngakongwa F., Niwemuhwezi J., Nixdorf R., Nugent L., Ramesh M., Salaliya VG., Sanga SS., Schulz G., Shamba D., Slade M., Swai G., Wagner M., Puschner B., Repper J. UPSIDES Cross-Site Implementation Manual: Generic Field Version, UPSIDES Project 2023.
PRIZE (2019-2023)
The Prize research project piloted peer-led recovery groups for people with psychosis in South Africa (PRIZE) and ran a randomized feasibility trial. During delays to commencement of the work, interviews were undertaken to explore the experieriences of people with psychosis of Covid-19. Imroc provided support and training in Recovery and Peer Support.
Carrie Brooke-Sumner, Bongwekazi Rapiya, Bronwyn Myers, Inge Petersen, Charlotte Hanlon, Julie Repper, Laura Asher (2024) COVID-19 experience of people with severe mental health conditions and families in South Africa. South African Journal of Psychiatry | Vol 30 | a2207 |DOI: https://doi.org/10.4102/sajpsychiatry.v30i0.2207
Submitted to Epidemiology and Psychiatric Services
Laura Asher, Carrie Brooke-Sumner, Bongwekazi Rapiya, Julie Repper, Tarylee Reddy, Bronwyn Myers, Gill Faris, Charlotte Hanlon, Inge Petersen (2024) Peer-led recovery groups for people with psychosis in South Africa (PRIZE): results of a randomized controlled feasibility trial
ENRICH
The ENRICH trial developed, piloted and trialed a peer support intervention to reduce readmission to inpatient psychiatric care in the year post-discharge. The programme also developed a peer support fidelity index and evaluated the impact of peer support on peer workers. Imroc provided specialist expertise in peer support.
Gillard S, Foster R, White S, Healey A, Bremner S, Gibson S, Goldsmith L, MarksMorshead R, Patel A, Patel S, Repper J, Rinaldi M, Simpson A, Ussher M, Woprner J, Priebe S (2023) . Peer support for discharge from inpatient to community mental health care: the ENRICH research programme. Programme Grants Appl Res 2023;11(8). https://doi.org/10.3310/LQKP9822
Sarah White, Rahul Bhattacharya, Stephen Bremner, Alison Faulkner, Rhiannon Foster, Sarah Gibson, Lucy Goldsmith , Daniella Harnett, Mike Lucock, Akshaykumar Patel, Stefan Priebe, Julie Repper, Miles Rinaldi, Anthony Salla, Alan Simpson, Michael Ussher and Steve Gillard (2023) Predictors of engagement with peer support: analysis of data from a randomised controlled trial of one-to-one peer support for discharge from inpatient psychiatric care. International Journal of Social Psychiatry 2023, Vol. 69(4) 994–1003
CSTACS (2022-2024)
The Citizen Science To Achieve Coproduction at Scale (C-STACS) study applied a citizen science approach to mental health research. It ran two citizen science projectsin collaboration with the NIHR Biomedical Research Centre.
Citizen science project 1: Managing mental health challenges is described at https://www.researchintorecovery.com/research/c-stacs/citizen-science-self-management/
Citizen science project 2: Envisioning recovery support is described at https://www.researchintorecovery.com/citizen-science-envisioning-recovery-support/
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Todowede O, Ashmore A, Boyd D, Rennick-Egglestone S, Moran S, Rimmer K, Repper J, Kotera Y, Ørjasæter KB, Rowe M, Sweeney A, Robotham D, Lewandowski F, Katsampa D, Ali Y, Slade M. A systematic review of citizen science as a novel approach to mental health research: qualitative evidence synthesis. CRD42022316042.
RECOLLECT
RECOLLECT stands for Recovery Colleges Characterisation and Testing, and is a programme of research investigating Recovery Colleges. Recollect has been awarded two National Institute of Health Research (NIHR) grants to further understanding of Recovery Colleges in England: a programme development grant (reference RP-DG-0615-10008, 2017-2018) and a programme grant (reference 200605, 2020-2025).
RECOLLECT 1 addressed three questions:
What are the defining characteristics of a Recovery College, and how does it differ from other medical and adult education approaches?
How do Recovery Colleges work, and how do they benefit service users?
Who uses Recovery Colleges?
RECOLLECT 2 aims to address how Recovery Colleges can provide the most benefit to people who use mental health services. It will:
Explore the characteristics of Recovery Colleges and how closely they follow the developed fidelity measure
Establish the costs associated with Recovery Colleges
Look at how Recovery Colleges impact student outcomes at 4, 8 and 12 months after joining
Explore the relationship between a Recovery College’s fidelity score and student outcomes for those who have recently used mental health services
Refine the previously developed change model for service user and students
Asses the effectiveness and cost effectiveness of Recovery Colleges
Examine the relationship between Recovery Colleges, student outcomes and resource use.
Establish the wider (organisational and contextual) factors influencing fidelity and outcomes
Finalise the programme theory of RECOLLECT
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Toney R, Knight J, Hamill K, Taylor A, Henderson C, Crowther A, Meddings S, Barbic S, Jennings H, Pollock K, Bates P, Repper J, Slade M (2019) Development and evaluation of a Recovery College fidelity measure, Canadian Journal of Psychiatry, 64, 405-414
Bowness B, Hayes D, Stepanian K, Anfossi A, Taylor A, Crowther A, Meddings S, Osman Y, Grant J, Repper J, Ronaldson A, Slade M, Henderson C (2023) Who uses Recovery Colleges? Casemix analysis of sociodemographic and clinical characteristics and representativeness of Recovery College students, Psychiatric Rehabilitation Journal, 46, 211-215
Hayes D, Hunter-Brown H, Camacho E, McPhilbin M, Elliott R, Ronaldson A, Bakolis I, Repper J, Meddings S, Stergiopoulos V, Brophy L, Miyamoto Y, Castelein S, Klevan T, Elton D, Grant-Rowles J, Kotera Y, Henderson C, Slade M on behalf of the RECOLLECT International Research Consortium (2023) Recovery College characteristics, fidelity, commissioning models and unit costs: a cross-sectional global survey of 28 countries, Lancet Psychiatry, 10, 768-779.
Kotera Y, Ronaldson A, Hayes D, Hunter-Brown H, McPhilbin M, Dunnett D, Jebara T, Takhi S, Masuda T, Camacho E, Bakolis I, Repper J, Meddings S, Stergiopoulos V, Brophy L, De Ruysscher C, Okoliyski M, Kubinová P, Eplov L, Toernes C, Narusson D, Tinland A, Puschner B, Hiltensperger R, Lucchi F, Miyamoto Y, Castelein S, Borg M, Klevan T, Meng R, Sornchai C, Tiengtom K, Farkas M, Jones H, Moore E, Butler A, Mpango R, Tse S, Kondor Z, Ryan M, Zuaboni G, Elton D, Grant-Rowles J, McNaughton R, Harcla C, Vanderplasschen W, Arbour S, Silverstone D, Bejerholm U, Powell C, Ochoa S, Garcia-Franco M, Tolonen J, Yeo C, Charles A, Jepps J, Simpson A, Kellerman V, Todowede O, Asher L, Murakami M, Hopkins L, Jahau N, Arakawa N, Scanferla E, Henderson C, Slade M (2024) Cross-cultural insights from two global mental health studies: self-enhancement and ingroup biases, International Journal of Mental Health and Addiction.
Kotera Y, Miyamoto Y, Vilar-Lluch S, Aizawa I, Reilly O, Miwa A, Murakami M, Stergiopoulos V, Kroon H, Giles K, Garner K, Ronaldson A, McPhilbin M, Jebara T, Takhi S, Repper J, Meddings S, Jepps, J, Simpson AJ, Kellerman V, Arakawa N, Henderson C, Slade M, Eguchi, S, Cross-cultural comparison of Recovery College implementation between Japan and England: Corpus-based discourse analysis. International Journal of Mental Health and Addiction,
Publications by Imroc research team 2019-2024
Many Imroc leaders, consultants and trainers have experience of research and we include a list of their publications from the last decade to demonstrate the diverse range of interests, experience and expertise of people working for and with Imroc.