Co-produced, peer supported post-diagnostic dementia support: a realist evaluation of Recovery College courses

Objective: A dementia diagnosis can be life changing. Recovery College courses may help people adjust to a diagnosis enabling them to live positively by adopting problem-solving approaches. Little is known about Recovery College courses for people with dementia. This study aimed to examine what works, how and for whom, in what contexts. Method : A realist evaluation set in four English mental health services collected interview data, ethnographic observations and documentary evidence on five courses. A realist logic of analysis developed causal explanations. Results : Observation data from five courses and interviews with 13 tutors (3 people with dementia) and 32 course attendees (8 people with dementia) supported development of four overarching Context-Mechanism-Outcome Configurations (26 granular CMOCs) related to the staging of a course. A shared commitment to the ethos of co-production across staff and peer tutors was essential to the success of setting-up and running courses; attendance at courses was facilitated by people known to attendees; delivery of the course foregrounded principles of problem-solving, reducing stigma and moving forward with hope; course evaluation was a challenge. Conclusion: Recovery-focused post-diagnostic support can enable people with dementia to consider a hopeful future; courses must be inclusive and accessible.