Abstract
The San Patrignano drug recovery community, Italy, is regarded as one of the most successful in the world. However, if this model is to be transferred to other countries, it is necessary to clarify its underlying mechanisms and how far their success is context dependent. This qualitative study investigated these features of the San Patrignano model. Data collection included semi-structured interviews with six key stakeholders and 10 days’ observational field notes. Data were synthesised using frameworks and analysis was informed by realist principles. Individual level mechanisms include: commitment to change, removal from former social environment, communal living, peer mentor with lived experience and meaningful work. These operate in the context of a free of charge, long term (3–4 year) residential community. Organisational level mechanisms are: visionary leadership, staff dedication, social enterprise and adaptable learning. Organisational contextual factors include: a gap in suitable provision for drug recovery and the region’s high level of social capital. Articulating the programme theory of the recovery model and its contextual dependency helps clarify which elements should be transferred and how far they need to be adapted for different socio-cultural settings. The recognition of context is crucial when considering transfer of effective complex interventions across countries.
Acknowledgements
We would like to acknowledge the San Patrignano community, Italy. In particular, those members of the community who participated in the intensive 10 day international workshop held in Coriano, Rimini in March/ April 2017. We are particularly grateful to the key stakeholders from San Patrignano who gave so willingly of their time, knowledge and insight by participating in research interviews. We also wish to thank the founder of Independence from Drugs and Alcohol Scotland (IFDAS). Finally, we thank the anonymous reviewers whose comments helped improve the article.
Disclosure statement
No potential conflict of interest was reported by the author(s).