Assessing personal recovery in individuals with severe mental illness: validation of the Dutch Brief INSPIRE-O

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Abstract
Purpose: Recovery is a key objective in mental health services for people with severe mental illness (SMI). In addition to clinical and functional recovery, personal recovery has gained increasing attention. The CHIME Framework identifies five personal recovery processes—Connectedness, Hope, Identity, Meaning, Empowerment—and is the theoretical foundation for the Brief INSPIRE, a validated Patient-Rated Experience Measure (PREM) to evaluate recovery support. Brief INSPIRE was modified to a five-item Patient-Rated Outcome Measure (PROM) assessing recovery, called Brief INSPIRE-Outcome (Brief INSPIRE-O). Subject of this study are the psychometric properties of the Brief INSPIRE-O. Methods: Data on validity and reliability gathered through annual routine outcome monitoring were collected for 861 individuals with SMI of Flexible Assertive Community Treatment teams and a follow-up measurement was available for 232 of these individuals. Test–retest reliability was evaluated in a separate subset of 30 individuals with SMI. Results: The Brief INSPIRE-O shows good internal consistency (Cronbach’s alpha 0.77), test–retest reliability, construct validity, sensitivity to change and no floor or ceiling effects. Furthermore, change in Brief INSPIRE-O was positively related to changes in quality of life and negatively to problems in clinical functioning and unmet care need. Conclusion: Brief INSPIRE-O can be used for research and monitoring to better understand and improve processes of personal recovery in individuals with SMI.

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