Ensuring that Recovery Colleges are Accessible to Family Carers - Lincolnshire Recovery College
Written by Bryher Bowness & Amy Day
Contribution from Dan Flesbourne
Introduction by Rachel Perkins
How to cite this paper:
To reference this paper, please use the citation below:
Bowness, B. & Day, A. (2025). Ensuring that Recovery Colleges are Accessible to Family Carers. Recovery Colleges: Sharing Our Experience series. Imroc.
Introduction
‘Recovery Colleges Sharing Our Experience’ Series
This is the third paper in the Imroc Recovery Colleges ‘Sharing Our Experience’ series. These are designed to explore different facets of Recovery Colleges and how the principles on which they are based can be realised in different contexts.
The first paper in the series, authored by colleagues from the Ontario Shores Recovery College provided insights into establishing a Recovery College in a largely clinical mental health service and the role that it had in driving forward recovery-oriented practice across the whole mental health system.
The second paper in the series describes the innovative ways in which Tower Hamlets Recovery College in London significantly improved the extent to which it served the diverse communities in the area.
In this third paper in the series, colleagues from the Lincolnshire Recovery College address the ways in which a Recovery College can be inclusive of unpaid family carers. They share their experience of establishing courses for family carers and the challenges and benefits of doing so.
In this third paper in the series, colleagues from the Lincolnshire Recovery College address the ways in which a Recovery College can be inclusive of unpaid family carers. They share their experience of establishing courses for family carers and the challenges and benefits of doing so.
Established in 2014, the Lincolnshire Recovery College serves a large rural county with a population of 768,400 people spread over 5,921 square miles. The College has grown significantly since its inception and now serves some 900 people per year.
During the Covid-19 pandemic, when many carers reported feeling particularly isolated and unsupported. As the ‘Carer Governor’ at Lincolnshire Partnership NHS Foundation Trust describes, “it became clear that compassion fatigue/burnout was a common theme they desperately struggled to manage.” Therefore, a compassion fatigue course was co-produced with unpaid family carers in the area. Subsequently, a post within the Recovery College was created to lead on the co-production and facilitation of specific courses for family carers.
Initially, despite offering both on-line and in person courses at different times of the day, the level of attendance was low. This is a problem reported by many Recovery Colleges who have established courses for family carers. Lincolnshire Recovery College set about understanding this challenge by recognising the importance of listening to family carers. Co-production is one of the key guiding principles of Recovery Colleges. We were particularly impressed by the way in which Lincolnshire Recovery College worked in partnership with family carers and local carer support services to understand the barriers and co-produce solutions that increased attendance numbers dramatically. Equally impressive is the way in which bringing together Recovery College students, staff, researchers and other stakeholders generated ideas about making Recovery Colleges more inclusive of, and accessible for, family carers.
A further guiding principle of Recovery Colleges is that they are ‘inclusive’ to ‘open to all’, yet often Recovery Colleges struggle to make a reality of this in relation to family carers. Recovery is often described as a ‘personal journey’, yet it is not a journey travelled alone. It is a journey travelled in the context of a culture and community, and most importantly, in the context of a family. Family carers in effect face two challenges of recovery: supporting their loved ones in their journey and their own personal journey resulting from the impact of the mental health challenges of the person they love on their own lives, experience and relationships. It is vital, therefore, that Recovery Colleges are inclusive of, and accessible to, family carers. This paper describes ideas about how this might be achieved drawn from a webinar in that brought Recovery College students, staff, researchers and other stakeholders.
We would like to thank Lincolnshire Recovery College for generously sharing their experiences and the lessons they have learned in ensuring that their Recovery College is inclusive of, and addresses the recovery challenges faced by, family carers. We are sure that their experience and insights will be of use to other Recovery Colleges.
- Rachel Perkins, Imroc Senior Consultant
Background
The term ‘carer’ is used to describe a wide range of people who provide substantial informal support to a family member or friend with a disability, illness, or mental health challenge. However, many people do not recognise themselves as carers (Lloyd, 2006), seeing themselves as parents, partners, siblings, or friends, for example. These relationships are often more complex and reciprocal (Molyneaux et al., 2011), and the categories ‘carer’ and ‘cared for’ are dynamic and not mutually exclusive. In this paper, we use the term ‘family carer’, where ‘family’ not only refers to biological bonds, but also our chosen families and all those in our networks who may be providing support to those experiencing mental health challenges.
There are roughly 8.8m million family carers in the UK, with approximately 13% providing care for someone with mental health challenges (Carers UK, 2019). These people are often essential to the recovery journeys of the people they care for, especially since the deinstitutionalisation and reduction of formal care has placed increased responsibility on them (Novella, 2010).
The State of Caring Survey (Carers UK, 2023) revealed that carers often report poor mental and physical health, constant worry about the person they care for, and financial strain. Many also report feeling unrecognised and unsupported by healthcare services. Family carers experience their own recovery journeys that are deeply interconnected with those they care for (Wyder & Bland, 2014).
In this paper, we explore the ways that Recovery Colleges can offer support to family carers, and how the Recovery College approach may be adapted to be more inclusive for their specific needs. We have shared our experiences of establishing courses specifically for family carers in Lincolnshire Partnership Foundation Trust (LPFT), including the challenges and benefits of doing this. We hope our experiences can inspire other Colleges to think about the ways that they may welcome family carers through their (online and physical) doors.
Family Carers and Recovery Colleges
Since the first Recovery College was established in England in 2009 (Rinaldi & Wybourn, 2011), the number of Colleges has grown to 88, serving over 360,000 students annually (Hayes et al., 2023). These Colleges operate on the principles of co-learning, where individuals with lived experience of mental health challenges, family carers, professionals, and community members learn together as ‘students’.
Recovery Colleges are well-documented as benefiting people who use services, for example, improving self-esteem and social inclusion (Thériault et al., 2020), and promoting recovery-oriented practices and other benefits to professionals who attend courses (Crowther et al., 2019). However, the experiences of family carers in these settings has not been investigated, even though family carers have distinct perspectives on recovery and mental health treatment (Perkins & Repper, 1998; Jacob et al., 2015).
To explore the provision for and experiences of family carers in greater depth, Bryher Bowness, one of the authors of this paper, facilitated online focus groups and interviews with 23 family carers (trainers and students) across different Recovery Colleges in England (Bowness et al., 2025). The family carers who participated emphasised how life-changing Recovery Colleges can be. Beyond gaining and sharing knowledge about mental health experiences and learning ways to navigate mental health services, family carers also developed essential insights and built skills for their own recovery journeys. Participants shared how the educational experience helped their relationships with the individuals they care for, and fostered hope, personal resilience, and growth.
The six themes developed from the study illustrate these benefits, as well as some limitations of Recovery Colleges for family carers:
1. The ‘Carer’ Identity is Not Clearcut
Many participants had not identified as ‘carers’ previously, seeing themselves instead as family members, professionals, or individuals dealing with their own mental health challenges. These multifaceted identities influenced the way they sought out and journeyed through Recovery Colleges.
2. The Recovery Ethos Applies to Family Carers Too
Participants described traumatic experiences that they had encountered whilst caring, and Recovery Colleges offer a crucial space for family carers to realise that recovery principles apply to them as well. Many found that these educational experiences helped “save” or reshape their relationships with those they supported, while also advancing their own recovery journeys.
3. The Power of Lived Experience
The co-production model of Recovery Colleges, where family carers collaborate with and learn from trainers and other students with diverse experiences, enriched the learning environment. This opportunity deepened their understanding of mental health and caregiving.
4. An Educational Focus is Appealing
Family carers were drawn to the educational focus of Recovery Colleges, which contrasted to and complemented support groups or therapeutic offers. They sought to expand their knowledge and skills to better manage their caregiving roles.
5. Family Carers Deserve Recognition and Provision
Family carers often felt overlooked within healthcare and support systems, and some also felt this in Recovery Colleges, necessitating their consistent recognition across all aspects of Recovery College programming. Family carers also described carer-specific courses as “brilliant” where these were available, indicating the benefits of Recovery Colleges intentionally tailoring to their needs.
6. Reaching Out and Fitting Around Family Carers
Very few family carers accessed Recovery Colleges, and increasing outreach (including to family carers from diverse communities) was a priority for participants. They suggested various strategies, such as offering flexible scheduling of courses to align with family carers’ often busy lives, and also increasing awareness. It was recognised that this would require additional resources.
Lincolnshire Recovery College
With a growing awareness of the challenges faced by family carers in accessing Recovery Colleges The Lincolnshire Recovery College have developed their approach in order to consider family carer needs. Lincolnshire is a large, rural county with a population of approximately 768,400 (Census, 2021) spread over 5,921 square miles, making it the fourth-largest county in England. Lincolnshire Partnership NHS Foundation Trust (LPFT) was established in 2007 and provides mental health services, as well as support for individuals with learning disabilities and autism, across the county.
The Lincolnshire Recovery College was launched in 2014, following the principles outlined by ImROC (2012). Its primary aim is to provide recovery-focused education to individuals aged 16 and over who live, work, or study in Lincolnshire. The College does not require referrals - students simply choose the sessions they wish to attend and complete a short registration form.
Over the last decade, the College has grown significantly, offering a diverse curriculum of over 40 courses both online and in person. Enrolments increased from just under 300 students in 2020 to nearly 900 in 2023/24. One key area of development has been the creation and inclusion of courses specifically tailored for carers. This initiative was catalysed during the COVID-19 pandemic when many carers reported feeling isolated and unsupported. In the narrative Below, Dan Fleshbourne describes the approach that LPFT took in acknowledging and accommodating the needs of carers within their Recovery College, beginning with his appointment as a ‘carer governor’.
Dan Fleshbourne - Carer Governor, LPFT
I was appointed as a ‘carer governor’ for LPFT Council of Governors during the COVID pandemic. This role allowed me to use my own lived experience of being a young carer as well as my current experience as a family carer. At the time I spoke a lot with other family carers through the LPFT Carers education and support group. This group is open to anyone who looks after someone with mental health challenges, autism and or a learning disability e.g. staff, LPFT carers and members of the public. It provides a space for carers to learn together about different mental health topics, guest speakers are invited, and the sessions are shaped by what the carers themselves say they would like to learn about; it may be a particular mental health condition, medication, available support or a particular service. Through conversations in this group, it became clear that compassion fatigue/burnout was a common theme they desperately struggled to manage. There was no general psychoeducational support that offered self-help to support unpaid family carers to avoid crises or developing poor mental health themselves. In my Governor role, I called for this to be addressed, and as a result, Lincolnshire Recovery College was engaged to develop a compassion fatigue course, co-produced with LPFT unpaid family carers.
Supported by the programme of work for the Adult Community Mental Health Transformation, the Recovery College were able to recruit an additional member of staff whose role included leading on the co-production and facilitation of specific courses for family carers. When work started to co-produce the first course about compassion fatigue, I was part of a group of carers involved in sharing our experiences and expertise. The co-production group included both family carers and those working with carers in a professional capacity. It included people from LPFT’s Carer council, (which is responsible for ensuring that the Carer voice is heard across the Trust and at Board level), people from Carers First (a charity offering support from and to carers), and people who access the Carers Education group which is run by LPFT Carer leads.
In early 2022, when a post became vacant, I was shortlisted for interview and then successfully employed by the Lincolnshire Recovery College. In this role I was able to support family carers by providing opportunities for them to learn together about mental health and wellbeing via the Recovery College. As part of my role I worked to further develop relationships with stakeholders and the Lincolnshire family carer community to ensure that their voices were part of the ongoing scope and development of courses. When I commenced in post it was evident that when the Recovery College had first begun delivering family carer courses, despite offering sessions both online and in person and at different times, the level of attendance was low, and it was important to hear from family carers to understand this.
I knew from my own experiences and from conversations with other family carers that it was essential to recognise that family carers may be isolated and overwhelmed. There are also limited opportunities to identify them and engage with them. Therefore, it was important to make connections with carers, share what we were working on and gather feedback by being present and meeting people face-to-face and in an environment where they felt comfortable. On reflection, this itself presented challenges as it was extremely time-consuming travelling across the county and required effort and planning to be able to access small groups in disparate areas of Lincolnshire but was also essential to create courses based on family carers input ideas and experiences.
Under the Care Act 2014, Lincolnshire County Council has the statutory responsibility to support carers. They also contract the Lincolnshire Carers Service (Serco) and Carers First to provide this service. I knew that it was vital to work with these and other stakeholders to facilitate engagement with carer communities, to involve them in co-production opportunities and increase course attendance, so I forged partnerships with Carers First.
In our engagement work, carers frequently voiced positive feedback about the idea of courses for carers, so we knew the unmet need was there. However, when we began to run courses, the attendee numbers remained low. I explored the reasons for this with carers via informal discussions at identified community carer groups, Carers First group sessions, LPFT carer forums and LPFT carer meetings. A common theme expressed in feedback was that carers struggled to juggle their caring role with course attendance: “Great course, but I can’t leave my cared for” and “I don’t have any time to spare for myself.”
As a solution, we decided to deliver the courses directly to carers in the community rather than them coming to an unfamiliar NHS venue at a time when they did not have support arrangements in place. This was piloted with the Carers First Lincoln support group. This was a large group of 20-30 carers who met monthly. The people who went already had arrangements in place to look after the person they cared for. We found that facilitating the sessions in a space that felt comfortable and where carers could attend without worrying about organising additional support for the person they care for, gave them access to sessions that they may not have otherwise been able to come to.
Using this approach, the Carers’ Compassion Fatigue course was re-launched, and the feedback was positive. Many carers who attended said that before the course, they hadn’t recognised their own struggle with burnout and didn’t know of the support available in Lincolnshire. Average attendee numbers increased from 4.5 learners per session to 16.8 learners per session.
Feedback from the Carers compassion fatigue course:
“The facilitator was good at explaining the impact of the caring and empathizing what they go through due to personal experiences. The session was delivered in a fun and informative way and had group interaction and asks for feedback and questions, the content of course was extremely good.”
“The range of subjects is excellent, and the course give ideas or suggestions on how things can be better (solutions). I like that the emphasis is on the person making a change and taking responsibility for themselves.”
“Very well delivered. The facilitator is very knowledgeable, understanding and patient, kept everyone engaged and the flow going. We certainly need this type of course.”
“Relaxed informal approach. Could relate to work and home situations.”
Challenges faced, lessons learnt and future developments
During the cycle of scoping, co-production, launch and development of the Lincolnshire Recovery Colleges courses specifically for family carers we have identified areas of challenge and opportunities for learning. We have been able to make changes in response to what we have learnt and overcome. This is an ongoing process of feedback, reflection, review and evaluation that enables the College to provide a safe community learning space that benefits and supports the mental health and wellbeing needs of family carers.
Promotion: Many family carers do not self-identify as such, and as a result, they may not recognise the relevance of the courses to their own experiences. This has made it difficult to promote the courses effectively. The college has worked hard to build community links and foster relationships with other carer groups to reach those who may not acknowledge their own need for support.
Geography: Lincolnshire is a large, rural county, and the Recovery College has faced difficulties in reaching family carers across the area. Covering such a vast geographical region with a small team has sometimes limited the frequency of courses and access for carers.
“As a small team, it can at times be challenging to cover a large geographical area, this can create difficulties and reduce the frequency of courses being scheduled on the timetable.” - Peer Trainer
Support Needs: During discussions with family carers, it has been highlighted that they sometimes feel angry, upset, and frustrated with the social care and support system. The course topics can lead to a realisation that the family carer needs support and extra help. It is important to ensure that the staff facilitating the sessions are able to signpost to, and have an understanding of, the support and services that are available, and can relate to the experience of navigating these. Emotional outpouring is not uncommon and should be supported within the teaching environment. The emotional needs of family carers can be challenging to address during courses. Many family carers attend the courses with emotional struggles that they have been masking in their caregiving role. The College has had to ensure that staff are equipped to support family carers through these difficult moments and that time is afforded where appropriate for learners to share experiences and express their emotions having lived experience and ability to empathise from a peer perspective has been a key element for the person in the Carer Lead role in the College.
“Managing carer expectations and emotional needs during courses… Carers sometimes feel angry towards a system they think hasn’t supported them. The course topics can frequently lead to a realisation that the carer needs support and extra help.” - Peer Trainer
Upskilling the Workforce: As awareness of the carer-focused courses continued to grow, requests came in for the Recovery College to extend its offer beyond family carers themselves to the wider LPFT workforce. Recognising the importance of educating staff who interact with carers, the College developed a Carer Awareness session specifically for LPFT staff. Co-produced with carers from LPFT, the LPFT Carers Council, and Carers First, the course included content that highlighted the challenges family carers face and how professionals can support them more effectively. A version of the course was also created for the Recovery College public facing timetable and can be accessed by anyone aged 16+ in Lincolnshire.
The co-production of the carers compassion fatigue session has been a catalyst for the College to make changes to work in a more carer aware way. It is now a requirement that all staff members attend the Carer Awareness training; this provides them with information and the confidence to be able to signpost students to support if required. A Peer Trainer has been employed within the Carer Lead post for college, and we continue to work together with the LPFT Carers education group, carer champions across LPFT, and Lincolnshire Carers First.
Student feedback has shaped the growth of new courses for family carers. The College offer now includes ‘Who is a carer?’, ‘A workshop for carers – surviving the summer holidays’, and created together with MacMillan and family carers supporting people with a cancer diagnosis ‘Cancer - a carers perspective’ The Carers Compassion Fatigue session has undergone a session review and evaluation by those who co-produced it, together with some students who attended, it is now offered as a single session addressing ‘Carer burnout’ and includes compassion fatigue as an element within this.
Practical Recommendations and Insights for Recovery Colleges: Making Recovery Colleges Inclusive and Accessible for Family Carers
In order for Recovery Colleges to remain faithful to their principle of ‘inclusive for everyone’, the ImROC briefing paper ‘Recovery College 10 Years On’ recommends that more needs to be done to ensure Recovery Colleges are accessible to the family carers of people experiencing mental health challenges (Perkins et al., 2018). They recommended recruiting ‘carer’ peer trainers and organising courses explicitly directed towards those supporting someone with mental health challenges. But a national survey completed by 62 managers of Recovery Colleges in England in 2021 (carried out by the RECOLLECT 2 research team), found that whilst 72.4% of Colleges had run a course specifically about caring, only 31% had appointed a ‘carer lead’ into their team (Bowness et al., 2025).
Following the focus group study described earlier in this paper (Bowness et al., 2025), the research team organised an online seminar to discuss the findings and think about ways to make Recovery Colleges more inclusive and accessible for family carers. They advertised this event through various international and national Recovery College Networks (including Imroc), other researchers in the field, and the participating Recovery Colleges. 80 Recovery College students, staff, researchers and other healthcare stakeholders came together in the session.
Using the suggestions from participants in the focus groups and attendees of the webinar, we have compiled the following recommendations for Recovery Colleges:
1. Making Recovery Colleges More Relevant for Family Carers
Participants in the research felt Recovery Colleges should consider the interests of family carers in all their courses (the majority of which are shared learning environments where family carers, people using services and staff are all students). One participant shared how their Recovery College had a family carer on a quality assurance panel for new courses. Moreover, incorporating family carers’ stories, quotes, and videos into courses was recommended to make the content more relatable. It was also suggested that increasing the number of trainers with lived experience of caregiving could help ensure content reflects their perspective. Appointing a specific family carer lead or carer champion may help to maintain this momentum.
Participants also suggested Recovery Colleges could respond to the unique needs of family carers by codesigning more courses specifically relating to caring issues. Examples included courses focusing on compassion fatigue and burnout (like those described in our case study from Lincolnshire), and ways to care for yourself whilst caring. Offering courses for supporting someone with a specific condition, or specific family role (e.g. adult siblings, fathers, young carers), were also mentioned. Highlighting any family carer-specific courses in the prospectus and co-producing these courses with specialist services and carer charities were also suggested as effective strategies. Contributors also stressed the importance of providing information about available support services and practical advice for family carers navigating the system. Connecting with NHS carer leads and initiatives such as the Triangle of Care (Hannan, 2013) could further enhance relevance.
2. Improving Accessibility for Family Carers
Accessibility remains a critical challenge for family carers who often struggle to attend courses due to their caregiving responsibilities. To address this, participants recommended offering courses outside traditional working hours and providing flexible formats such as online sessions, webinars, podcasts, and printed handouts. If possible, practitioners, volunteers, or Peer Support Workers accompanying family carers to courses could also help ease logistical challenges, and support people to feel confident in attending alone.
Other recommendations included offering IT skills classes and access to computers to address digital exclusion, and conducting surveys or polls to determine carers’ availability. Shorter courses, introductory taster sessions, and virtual introductions to trainers could make it easier for family carers to participate. Funding for online courses accessible across the UK was also suggested, as many family carers are not local. Signposting to wider sources of support (emotional and practical) specifically for family carers should be offered. Analysing the feedback from family carers following courses, and also speaking to family carers who enrolled but did not attend, could also provide further insights into barriers and solutions.
3. Reaching Diverse Communities
To better serve diverse communities, Recovery Colleges must adopt inclusive strategies. Some Colleges avoided using the word ‘carer’ to be more inclusive and appeal to people who didn’t identify themselves as ‘carers’ but may benefit. Suggestions included increasing diversity among trainers and using language that resonates with different cultural groups. Perhaps terms like “wellbeing” and “hope” that carry less stigma than “mental health.” Outreach into underrepresented communities, forming partnerships with community groups, and offering courses in local languages were also highlighted as crucial steps.
It is also important to consider LGBT+ communities who are often particularly socially isolated (Aging Better, 2022) and poorly served by health and social services that make assumptions that everyone is heterosexual and where overt prejudice continues to exist (Social Care Institute for Excellence, 2024). Too often, “despite legal recognition of relationships, there is extensive evidence of LGBTQ+ people’s partners, carers and ‘families of choice’ not being valued or recognised in some care settings.” (Skills for Care, 2022). Sometimes estranged from, or having no, biological family, the real families of LGBT+ often comprise people from their chosen LGBT+ communities. It is important to understand the diverse lives and experience of LGBT+ people and be “respectful and inclusive of same sex partners and people’s ‘chosen family’ among friends, lovers and ex-lovers.” (Skills for Care, 2022).
Publicising Recovery College courses through faith groups, sports clubs, community groups and organisations and cultural radio stations could help reach a wider audience. Additionally, analysing enrolment data to identify underrepresented groups and offering arts-based courses, which often carry less stigma, were recommended strategies. Ensuring the use of inclusive language that is respectful to the full range of ‘family’ relationships and hosting courses in non-clinical, community-based settings could also help reduce barriers and make courses more appealing and accessible.
4. Raising Awareness About Recovery Colleges
Effective communication and marketing are essential to raise awareness of Recovery Colleges among family carers. Advertising in public spaces such as buses, shopping centres, libraries, gyms, and chemists could broaden visibility. Collaborating with healthcare professionals, such as GPs, social prescribers, and carer support groups, was identified as a key strategy for promoting Recovery Colleges.
Other suggestions included launching a UK-wide promotional campaign, appointing a marketing lead within each College, and building connections with education teams and workplaces. Participants recommended including family carers’ stories and testimonials in promotional materials to showcase the benefits of attending courses. Hosting open days or coffee mornings specifically for family carers could provide a welcoming introduction to the College. Finally,
Conclusion
In this paper, we have described the difficulties that family carers often experience in relation to Recovery Colleges. Although they are designed to be open to all, it is clear that there are barriers that prevent family carers from being able to access Recovery Colleges, or feeling welcomed, into them. We have provided examples from LPFT, where they we tried to overcome these barriers by bringing together family carer groups and concertedly focussing on what family carers need in order to benefit from Recovery Colleges. Through listening to the experiences of family carers, both informally and through research, it is possible to review our Recovery College practices. Many Recovery Colleges are at the beginning of the journey toward welcoming family carers, and we know that there is still much to do in order to make our Recovery Colleges accessible to all. We hope that in sharing our initial reflections and experiences, we can inspire others who are wrestling with the same challenges.
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