Abstract
Background/Objectives: Art-based community projects positively impact mental health recovery by fostering creativity, self-expression, and social engagement. Despite growing evidence on participatory art interventions, limited studies have used a mixed-methods approach to examine their effects. The present study examines how participation in the Artistic Couples project influences individuals' subjective perceptions of recovery, psychological well-being, and self-stigma. Methods: This exploratory multi-center study employed an embedded mixed-methods design, integrating qualitative Photovoice methodology with a quantitative pre-post survey. Participants (N = 30) from five mental health institutions across Catalonia engaged in collaborative art creation with local artists. Qualitative data from Photovoice discussions and semi-structured interviews were analyzed using thematic analysis, while quantitative data from standardized measures were examined using paired t-tests and correlation analysis. Results: Qualitative findings revealed the following three key themes: (1) artmaking as an artistic couple, emphasizing the collaborative process and art as a means of self-expression; (2) social connections, highlighting increased belonging, emotional support, and reduced loneliness; and (3) understanding mental health recovery, showcasing art's role in identity reconstruction and personal growth. Quantitative results indicated a significant improvement in the "Connecting and Belonging" subscale of the RAS-DS (t = -2.51; p = 0.023), particularly among women (t = -2.85; p = 0.019), suggesting enhanced social integration. However, no statistically significant changes were observed in overall recovery, well-being, or self-stigma scores. Conclusions: This study provides evidence that participatory community art projects enhance social connections and self-expression, which are key elements of mental health recovery. The findings suggest that creative collaborations facilitate emotional processing and challenge stigma. The improvement in social belonging supports integrating arts-based interventions in recovery-oriented care. Future research should examine long-term effects and gender-sensitive approaches.