Thriving in the City: An Urban Living Lab to Facilitate Recovery From Psychosis.

AIM: Protective factors and resources to recovery in urban milieus remain poorly understood, calling for user-led initiatives to develop relevant interventions embedded in patients' daily-life environments. Experience-based co-design is key to need-based interventions in real-life settings and calls for novel methodologies.

OBSERVATION: This multi-stakeholder (service users, psychiatrists, geographers, community actors and public authorities) initiative aims to identify key elements of an 'urban recovery milieu for psychosis' in Lausanne, Switzerland based on a Living Lab approach. Beyond questions of usage, feasibility and acceptability, we will identify which types of interventions are more useful for which group of patients. This pilot phase may pave the way towards a future randomized control trial and the definition of the most appropriate sample size for it.

RESULTS

Qualitative data are collected through field notes, audio-recorded walk-alongs, workshops and focus groups with care teams and participants. The quantitative analysis is based on observational and correlational study design. We will assess how 55 patients of two psychosis-specialized cohorts use the urban interventions in their day-to-day practices and monitor psychometric variables before and after the experimentation. The data stems from tailor-made questionnaires (City avoidance questionnaire, Urban remediation questionnaire, etc.), clinical rating scales (ASI, RAS, TEPS, ISMI and CRDPS) and routine follow-up procedures (SOFAS, GAF, CGI, WHOQOL and PAS).

DISCUSSION: Additionally, insights from this study will inform mental health plan on municipal level and be upscaled for broader public benefits.