TREE: a Dutch multi-centre (cluster) randomized trial of a recovery program of/for persons with severe mental illness

Background/Objectives: There is growing evidence for the effectiveness of several psychiatric rehabilitation interventions in helping people with severe mental illness building a meaningful life in the community. There is no evidence to determine whether a user developed and user run recovery program (TREE) supports recovery processes and reduces psychiatric symptoms in the participating group.

Methods: A randomized controlled trial was conducted on four Dutch sites. Sites were two supported housing centres, and two community mental health centres. At the two supported housing sites houses were the unit of randomization, at the community mental health sites patients were randomized individually. The experimental program consisted of a user run recovery group and short recovery courses, added to care as usual. The waitlist-control group received care as usual in the first year and could enter the experimental program in the second year. Patients with severe mental illness (n=175) were followed up for 24 months. Outcome measures were empowerment, mental health confidence, connectedness, quality of life, and positive, negative, and depressive symptoms. Regression analysis was used to explore the impact of the program.

Results: The program had a modest, significant positive effect on mental health confidence, depressive symptoms, negative symptoms and self esteem.

Discussion/Conclusions: A user developed/run recovery program helps reducing psychiatric symptoms and supports recovery processes of its participants.

Funding: Netherlands Organisation for Health Research and Development (grant no. 100003008), Stichting Beschermende Woonvormen Utrecht, Rivierduinen, Maastricht University.

Keywords: Recovery-oriented interventions, recovery interventions, treatment effectiveness.