In the main games, Shell Bell holders recover 1/8th of the damage they inflict to an opponent.
In Pixelmon, it seems that a shell bell user that switches in gains HP at the beginning of the turn (rather than at the end, after they deal damage). This is important in settings where Entry Hazards are up, and a FEAR mon is switched in (FEAR mons are typically level 1 pokemon having focus sash or sturdy).
TLDR: Shell Bell isn't supposed to be recovering HP at the beginning of a turn/recovering HP when no damage is dealt, but it does do so in this Pixelmon mod. The Shell Bell also shouldn't be recovering if the mon is switching in at the beginning of the turn (Ex: Poke 1 faints, Poke 2 with shell bell is brought in next turn) Poke 2 shouldn't recover HP.
Haven't tested it yet, but this bug might extend to Leftovers and Black Sludge as they are also HP-Recovering held items. They shouldn't be recovering anything if the pokemon is switching in at the beginning of a turn (it SHOULD work if it is the end of the turn though)