An evidence base for mental health promotion through supported education: A practical application of Antonovsky's salutogenic model of health

Abstract

Purpose This paper reviews the literature for evaluation studies that might fulfil the criteria of evidence-based medicine (EBM) in the specialism of ‘supported education for people with long-term mental health needs’, with a view to justifying the efficacy of these initiatives and attracting the associated funding. Design and methods A review of the literature was conducted for supported education evaluation studies that might fulfil the criteria of EBM. The methodologies of the studies found were examined both for appropriateness to the initiative being undertaken, and to what extent it complied with EBM. A recently developed and implemented evaluation methodology of supported education conducted over three years in a further education (FE) college (Morrison & Clift 2006) was then examined in the light of the above findings, with a view to attempting to overcome major difficulties and confirm outcomes. Results Currently, the literature has few examples of programme evaluations that meet EBM criteria, which might convince budget holders of the efficacy of supported education. However, those that are available have consensus in their findings of the positive outcomes and the associated causative reasons. For the future, a recently developed and implemented triangulated evaluation methodology, and using Antonovsky's short-form Sense of Coherence questionnaire (SOC-13) as a test, retest instrument, has been successful in answering the dichotomy of rigour with appropriateness, and issues of consistency of evaluation methods and reducing the multitude of measuring instruments found in present studies. Implications This research has government target implications for budget holders, health promotion staff and mental health teams working within the recovery model of health, in the collaborative use of resources to assist people recovering from or managing mental health difficulties to move forward in their lives. Conclusion This study offers an appropriate and rigorous methodology and test, retest instrument for a non-randomised control trial suitable for the social sciences, and especially for evaluating supported education initiatives, so that they can be properly validated and attract funding. It also supports the cost benefits of mental health promotion for those recovering from or managing their mental health needs.