As part of the College of Occupational Therapists' Mental Health Project, a survey of occupational therapists practising in mental health in the United Kingdom was conducted. A questionnaire was sent to 200 members of the Association of Occupational Therapists in Mental Health and achieved a 68.5% response rate. The majority of the 137 respondents were female, with Senior I staff between 20 and 30 years of age, who were unlikely to have worked in another area, forming the largest group. Although most had received additional training, they identified the need for more training, especially in aspects of occupational therapy. Most were managed by an occupational therapist and 96% received supervision. Community mental health was the most frequently reported area of work, with leisure, counselling, anxiety management and creative activities the most frequently used interventions. The respondents were committed to the core principles of occupational therapy and the need to develop outcome measures and evidence-based practice, and were concerned about moves to generic working. This study has provided data not only for the position paper on the way ahead for occupational therapy in mental health but also for individual occupational therapists and managers.

The future of occupational therapy in mental health has been a topic of reflection and debate. The Education and Research Board (now the Education and Practice Board) of the College of Occupational Therapists created a Working Group to develop a position paper on the way ahead for research, education and practice in mental health.Following consultation, the Working Group reviewed literature, examined current research and surveyed practitioners, managers and educators. From these findings, recommendations have been made which will lead to a firmer evidence base for the practice of occupational therapy in mental health, leading to a more effective use of the expertise of occupational therapists and an improved service for users.

The Climate Change and Health Adaptation Program (CCHAP) is a program within the First Nations Inuit Health Branch of Indigenous Services Canada (which was previously under the responsibility of Health Canada). The CCHAP supports Inuit and First Nation communities in mitigating and adapting to the health impacts of climate change. The impacts of climate change on Indigenous health can be observed in multiple areas including, but not limited to, food security, cultural medicines, mental health and landbased practices. This program seeks to address the needs of climate change and health in First Nation and Inuit communities to support resiliency and adaptation to a changing climate both now and in the future through its emphasis on youth and capacity building. The commentary is based on the Program’s eleven years of experience working with and for Indigenous communities and provides an overview of the CCHAP model and the work it has and continues to support. This paper demonstrates three examples of community-based projects to mitigate and adapt to the health impacts of climate change to demonstrate climate change resiliency within Indigenous communities.

Background Recovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020–2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges’ effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes.  Methods RECOLLECT comprises i) a national survey of Recovery Colleges, ii) a prospective cohort study to establish the relationship between fidelity, mechanisms of action and psychosocial outcomes, iii) a prospective cohort study to investigate effectiveness and cost-effectiveness, iv) a retrospective cohort study to determine the relationship between Recovery College use and outcomes and mental health service use, and v) organisational case studies to establish the contextual and organisational factors influencing fidelity and outcomes. The programme has been developed with input from individuals who have lived experience of mental health problems. A Lived Experience Advisory Panel will provide input into all stages of the research. Discussion RECOLLECT will provide the first rigorous evidence on the effectiveness and cost effectiveness of Recovery Colleges in England, to inform their prioritising, commissioning, and running. The validated RECOLLECT multilevel change model will confirm the active components of Recovery Colleges. The fidelity measure and evidence about the fidelity-outcome relationship will provide an empirically-based approach to develop Recovery Colleges, to maximise benefits for students. Findings will be disseminated through the study website (researchintorecovery.com/recollect) and via national and international Recovery College networks to maximise impact, and will shape policy on how Recovery Colleges can help those with mental health problems lead empowered, meaningful and fulfilling lives.

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