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From the early 1970s, the Italian model of community psychiatry and the Italian Reform Act (Law 180) was developed by Franco Basaglia and colleagues in the north-eastern part of Italy (Pergami et al, 1996). The intervention was focused on community based services such as day hospital, crisis intervention centres, sheltered accommodation and family homes (Pergami, 1992). Forty years later, national guidelines and practical implementation were mostly applied in a significant number of community services with the "closing down" of psychiatric hospitals. The most revolutionary Mental Health Act in Western countries was modeled on the guidelines of the World Health Organization but a number of problems in terms of provision of premises and number of staffed personnel at local and regional levels still remain to be addressed.
Due to the longstanding economic crisis, a recent investigation by Mencacci et al (2013) showed that, in the face of 1.200.000 Italians with psychiatric disease treated in psychiatric community services, trained personnel have decreased by 50% in the past ten years.
Towards this aim, the new Action Plan for Mental Health will focus on availability and patients involvement, continuity of care, personalization of therapeutic project and pathways of care, and flexible services oriented to patient's needs. Priorities of intervention will be based on early intervention in psychosis, common psychiatric disorders such as anxiety and depression in primary care, and disorders of infancy and adolescence. In order to obtain adequate implementation avoiding the pitfalls of Law 180, investigation and follow up from the Ministry of Health will be developed. A new national plan (based on the new Law 211/2011) will dismiss psychiatric patients form the custody to psychiatric services, avoiding custody as place of safety for patients. The ongoing plan showed that 1016 patients were discharged from custody in psychiatric hospital in the period 2011-2012, with the remaining 900 still to be sent to community services. The update of Law 180 will provide again the basis for an advanced model of community psychiatry in both European and American countries.
References
Mencacci C. Paper presented at the Nationa Congresso of the Italian Psychiatric Society, novembre 2013)
Pergami A (1992) Towards an impementation of the Italian model of community psychiatry. Psychaitric Bulletin 1992, 16, 90-92
Pergami A et al Medicine in Itay. Lancet, 348, 9028, 680
Competing interests:
No competing interests
03 February 2014
Andrea Pergami
Pyschiatrist
Department of Mental Health, Azienda Ospedaliera di Melegnano
Re: Use of the Mental Health Act in England shows year-on-year increase
From the early 1970s, the Italian model of community psychiatry and the Italian Reform Act (Law 180) was developed by Franco Basaglia and colleagues in the north-eastern part of Italy (Pergami et al, 1996). The intervention was focused on community based services such as day hospital, crisis intervention centres, sheltered accommodation and family homes (Pergami, 1992). Forty years later, national guidelines and practical implementation were mostly applied in a significant number of community services with the "closing down" of psychiatric hospitals. The most revolutionary Mental Health Act in Western countries was modeled on the guidelines of the World Health Organization but a number of problems in terms of provision of premises and number of staffed personnel at local and regional levels still remain to be addressed.
Due to the longstanding economic crisis, a recent investigation by Mencacci et al (2013) showed that, in the face of 1.200.000 Italians with psychiatric disease treated in psychiatric community services, trained personnel have decreased by 50% in the past ten years.
Towards this aim, the new Action Plan for Mental Health will focus on availability and patients involvement, continuity of care, personalization of therapeutic project and pathways of care, and flexible services oriented to patient's needs. Priorities of intervention will be based on early intervention in psychosis, common psychiatric disorders such as anxiety and depression in primary care, and disorders of infancy and adolescence. In order to obtain adequate implementation avoiding the pitfalls of Law 180, investigation and follow up from the Ministry of Health will be developed. A new national plan (based on the new Law 211/2011) will dismiss psychiatric patients form the custody to psychiatric services, avoiding custody as place of safety for patients. The ongoing plan showed that 1016 patients were discharged from custody in psychiatric hospital in the period 2011-2012, with the remaining 900 still to be sent to community services. The update of Law 180 will provide again the basis for an advanced model of community psychiatry in both European and American countries.
References
Mencacci C. Paper presented at the Nationa Congresso of the Italian Psychiatric Society, novembre 2013)
Pergami A (1992) Towards an impementation of the Italian model of community psychiatry. Psychaitric Bulletin 1992, 16, 90-92
Pergami A et al Medicine in Itay. Lancet, 348, 9028, 680
Competing interests: No competing interests