Development and evaluation of a mental health recovery priority measure for cross-cultural research: Global INSPIRE

Kotera, Yasuhiro; Hara, Akemi; Newby, Christopher; Miyamoto, Yuki; Ozaki, Akihiko; Ali, Yumna; Clinton, Pamela; Felix, Simon; John, Catherine; Inta, Natthapon; Slade, Mike

Abstract

Purpose
This study developed and evaluated a new personal recovery scale—Global INSPIRE—in English and Japanese, and compared responses between Japan and the UK. Personal recovery—living a satisfying and meaningful life despite mental health challenges—has gained attention in mental health. The widely-used CHIME framework identifies five recovery processes: Connectedness, Hope, Identity, Meaning, and Empowerment. Full INSPIRE evaluates whether service users feel supported in each CHIME process. However, emerging cross-cultural evidence indicates differences in the priority placed on each CHIME domain. No tool exists to assess recovery priorities, hindering cross-cultural research.

Methods
The 20-item self-completed Global INSPIRE was adapted from the Full INSPIRE to assess recovery priorities of both service users and non-service users. Participants in the UK (n=512) and Japan (n=507) completed the Global INSPIRE at baseline and two-week follow-up. Psychometric properties were evaluated, including reliability, test-retest stability, and discriminant validity with two established recovery scales—CORE-10 and QPR-15. Cross-national differences in recovery priorities were also examined.

Results
Both versions showed excellent reliability (α=0.91 UK; 0.97 Japan), test-retest stability (4/5 processes UK, 5/5 Japan), and acceptable model fit (CFI=0.80 UK; 0.85 Japan). Measurement invariance supported configural (CFI=0.89) and metric invariance (CFI=0.89) but not scalar invariance (CFI=0.83). Discriminant validity was supported by weak correlations with CORE-10 and QPR-15. UK participants prioritised Hope, Meaning, and Empowerment, while Japanese participants prioritised Identity.

Conclusion
Global INSPIRE is a reliable and culturally adaptable tool for assessing distinct recovery priorities. Future research should explore demographic differences and expand testing across diverse cultural contexts.

Citation

Kotera, Y., Hara, A., Newby, C., Miyamoto, Y., Ozaki, A., Ali, Y., Clinton, P., Felix, S., John, C., Inta, N., & Slade, M. (in press). Development and evaluation of a mental health recovery priority measure for cross-cultural research: Global INSPIRE. Social Psychiatry and Psychiatric Epidemiology,

• Journal Article Type: Article
• Acceptance Date: Jun 9, 2025
• Deposit Date: Jun 10, 2025
• Journal: Social Psychiatry and Psychiatric Epidemiology
• Print ISSN: 0933-7954
• Electronic ISSN: 1433-9285
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Keywords: mental health recovery; personal recovery; cross-cultural validation; scale development and validation; recovery priorities
• Public URL: https://nottingham-repository.worktribe.com/output/50167645