Addressing Challenges in Residential Facilities: Promoting Human Rights and Recovery While Pursuing Functional Autonomy.

Objective: Italian residential facilities (RFs) aim to promote human rights and recovery for individuals with severe mental disorders. Italian RFs can be distinguished into five main types: high-intensity rehabilitation (RF1), medium-intensity rehabilitation (RF2), medium-level support (RF3.1), high-level support (RF3.2), low-level support (RF3.3). This study aimed to assess the effectiveness of Italian RFs in achieving functional autonomy while upholding human rights and recovery.

Methods: Data on socio-demographics, clinical information, patient and staff assessments of functional autonomy, types of interventions, and RF performance in various domains were collected in a pilot study with a cross-sectional design. Descriptive and inferential analyses were conducted.

Results: Twelve RFs and 113 patients participated, with varying proportions in each RF type. RF1 patients were the oldest ( < 0.001) with the lowest functional autonomy ( < 0.001), while RF2 patients were the youngest ( < 0.001) with the lowest hospitalization rate ( < 0.001). RF3.1 patients had the highest employment rate ( = 0.024), while RF3.2 had the lowest employment rate ( = 0.024) and the longest service contact ( < 0.001). RF3.3 users had the highest functional autonomy ( < 0.001). The highest functional autonomy was in self-care which received the highest focus in objectives and interventions. Patients rated their functional autonomy higher than professionals ( < 0.001). RFs excelled in the "human rights" and "social interface" domains but performed poorly in "recovery-based practice," with RF1 having the lowest performance and RF3.3 the highest.

Conclusions: This pilot study suggests that Italian RFs generally aligne with their mission and human rights principles, but personalizing interventions and implementing recovery-oriented practices face challenges.