However, a psychotic or seriously disturbed patient is only assigned to a rehabilitative programme when there are identifiable areas of functioning that indicate the possibility of improvement. They mainly cater for subjects whose illness is of recent onset, but who are soon found to have problems with social functioning and autonomy. Such patients often require intensive care in a sheltered residential setting in order to help them recover the skills they have lost. The residential structures are organized in different ways according to the degree of shelter required and, above all, according to duration of stay and prescribed treatment or therapy. Communities are structures designed to meet the health and social welfare needs of psychiatric patients requiring therapeutic and rehabilitative assistance to underpin and develop their residual capacity for autonomy.
Treatment is provided in a sheltered residential setting, with no pre-determined time limits.
The various levels of shelter may coexist within a single structure or be provided by separate structures. These days, the Italian model of psychiatric care is organized so as to provide several differentiated kinds of treatment, chosen according to the prognosis for and characteristics of the psychiatric disorders concerned. Essentially, the aim is to reduce the need for hospitalization to a minimum and to limit its duration where unavoidable. This is achieved by operating within the patient's social context and family, by trying to prevent chronicization and by maintaining the patient in his own relational network. The aforesaid orientation has led to the closure of the traditional psychiatric hospitals and to the organization of prevention, treatment and rehabilitation on a local basis.