Abstract
BACKGROUND: Psychosocial interventions for people with mental illness are increasingly focusing on facilitating recovery and self-care. Despite evidence from Europe on the short-term effects of recovery self-planning programs for people discharged from crisis resolution teams, similar programs and supporting evidence in other countries or healthcare contexts are lacking, particularly regarding cultural adaptation and long-term assessment. This randomized controlled trial compared a 4-month peer-facilitated, recovery-focused self-illness management (Peer-RESIM) program for Chinese adults with first-episode psychosis with psychoeducation (PE) and treatment as usual (TAU). METHODS: Patients (N = 198) were recruited from four Integrated Community Centres for Mental Wellness in Hong Kong and randomly assigned to the Peer-RESIM, PE, or TAU group (66/group). The primary outcomes were recovery and functioning levels; the secondary outcomes were psychotic symptoms, problem-solving ability, rehospitalization rate, and service satisfaction. Assessments were conducted at baseline and immediate, 9, and 18 months postintervention. RESULTS: The generalized estimating equation test revealed that the Peer-RESIM group reported significantly greater improvements in recovery, functioning, problem-solving ability, psychotic symptoms, average duration of rehospitalizations, and service satisfaction (p = 0.01-0.04, small to large effect sizes) than the TAU group at all three posttests and the PE group at 18 months postintervention. CONCLUSIONS: The Peer-RESIM can enhance long-term recovery and self-care in adults with early-stage psychosis.