Feasibility, Acceptability, and Impact of Recovery-Oriented Practices in an Italian Community Mental Health Service: A Pilot Study

Abstract

Background: Over the past decade, Italy has made progress in adopting recovery-oriented approaches in mental health care, though full alignment with international guidelines remains incomplete. This study investigates the feasibility, acceptability, and impact of integrating recovery-oriented practices in an Italian Community Mental Health Service (CMHS), focusing on both user and professional perspectives to identify strengths and areas for improvement. Methods: A longitudinal pilot study was conducted at the South Verona CMHS. Data on users' socio-demographic and clinical characteristics, symptoms, functioning, needs, and autonomy were collected at baseline and six-month follow-up. Participants included individuals in supported accommodation and outpatient care. The Mental Health Recovery Star (MHRS) assessed recovery progress. Qualitative data from focus groups and interviews captured users' and professionals' experiences. Results: Nineteen professionals completed the MHRS with 25 users, who demonstrated significant improvements in MHRS scores (p = 0.003), romantic relationships (p < 0.001), employment (p < 0.001), functioning (p = 0.015), psychopathology (p = 0.001), functional autonomy (p = 0.003), and unmet needs (p = 0.026). Qualitative findings emphasized the value of a personalized, holistic approach but noted gaps in follow-up and shared decision-making. Focus groups (30 participants) highlighted recovery as a process of hope, meaning, and empowerment. Participants called for ongoing education, structural changes, and peer-support initiatives. Professionals reported increased motivation. Conclusions: Integrating recovery-oriented practices within the South Verona CMHS was both feasible and acceptable. The MHRS positively impacted service users' personal recovery and professionals' motivation. The study underscores the need for continued training, structural reforms, and peer-support initiatives to foster lasting changes and enhance CMHS practices.

Keywords: community mental health service; focus group; mental health recovery star; pilot study; recovery.

Figure 1

Key professionals’ impact assessment about the recovery implementation in the CMHS at BL and FU. Statements 1, 3, 5, 7, 9, and 11 were positive, while statements 2, 4, 6, 8, and 10 were negative. Likert scale, 1 = Strongly Disagree, 2 = Disagree, 3 = Neither agree nor disagree, 4 = Agree, 5 = Strongly Agree. Staff statements on impact assessments were the following. 1. I feel that service users can clearly communicate their support needs to me; 2. I’m not as motivated as I used to be to encourage positive service user engagement; 3. I feel that I am supporting service users on things that really matter to them; 4. I don’t know how much the service users I work with have progressed since they joined the service; 5. Supervision is used to help me think through my key work and support planning; 6. I often feel that I don’t know how to communicate with service users about the things that matter to them; 7. I can clearly see and evidence how the support needs of service users have changed in the time I have worked with them; 8. I don’t know how the service users I work with feel about the support I provide; 9. I feel service users are actively leading in their own recovery; 10. The impact the work I do has on service users’ lives is not picked up by current monitoring methods; 11. Our service reflects the needs and aspirations of service users and it is enriched by their contributions.

Figure 2

Service users’ impact assessment about the recovery implementation in the CMHS at BL and FU. Statements 1, 3, 5, 7, and 9 were positive statements about the service, whereas statements 2, 4, 6, 8, and 10 were negative. Likert scale, 1 = Strongly Disagree, 2 = Disagree, 3 = Neither agree nor disagree, 4 = Agree, 5 = Strongly Agree. Service users’ statements of impact assessments were the following. 1. I feel listened to when I talk about what support I need; 2. Positive engagement is difficult for me as staff aren’t interested in what I want to do; 3. Staff make me feel relaxed and welcome and I feel confident to approach them for support; 4. I don’t know how much I’ve progressed since joining the service; 5. I am made to feel important and that my opinions matter; 6. There are important areas in my life that I don’t know how to bring up in key working sessions; 7. I feel satisfied with the advice and support I receive relating to education, training and employment; 8. There aren’t enough opportunities to feedback on the support I receive; 9. I feel in control of my life, the decisions I make and the support I get; 10. I feel that I am stuck and don’t know what my next step should be.