The application of recovery principles within everyday mental health services is understudied.

We studied the implementation of a programme of intensive case management (ICM) emphasizing recovery principles in an Irish community mental health service.

Eighty service attenders with severe and enduring illness were randomized into groups

1. (1) receiving a programme of ICM,

2. (2) receiving treatment as usual (TAU).

Groups were compared before/after the programme for general psychopathology using the Brief psychiatric Rating Scale [BPRS] (clinician rated) and How are You? Scale (self-rated). The Functional Analysis of Care Environments [FACE] scale provided assessment of functional domains.

The overall group [mean age 44.5 ± 13.2 years; 60% male] had mean total Health of the Nation Outcome Scale [HoNOS] scale scores 10.5 ± 4.6 with impaired social functioning especially prominent (mean social subscale score 5.0 ± 2.7). The ICM group were younger (p < 0.01) with higher baseline scores on the HoNOS social subscale and BPRS (p < 0.05). An analysis of covariance, controlling for these baseline differences, indicated greater improvement in BPRS scores (p = 0.001), How are You? scores (p = 0.02) and FACE domains for cognition, symptoms and interpersonal relationships (all p < 0.001) in the ICM group. The ICM group underwent greater changes in structured daily activities that were linked to improved BPRS scores (p = 0.01).

A programme of ICM emphasizing recovery principles allowed significant improvement across psychopathological and functional domains. Improvements were linked to enhanced engagement with structured daily activities. Recovery-oriented practices can be integrated into existing mental health services and provided alongside traditional models of care.