The authors describe the historical evolution, from the 70’s onwards, of Addiction Services and associated Therapeutic Communities, to their ultimate integration in the network of Community Mental Health Services. These organisational developments - triggered by shifting user needs and clinical approaches - have changed professional knowledge and clinical pathways, mainly with patients with severe personality disorders, or "dual diagnosis". The article then presents an innovative experience, beginning in 2014, carried out by the Local Health Unit of Parma. Three integrated services were created - in the districts of Fidenza, South-East and Taro and Ceno valleys - comprising both Adult Psychiatry and Drug Addiction. The authors examine the integration process, in the district of Fidenza, that involved the main actors of the network, and among others, the therapeutic community "Casa di Lodesana". This therapeutic community has now adopted a systemic model, after having used, in the past, a linear approach. It currently offers rehabilitation interventions with different levels of therapeutic intensity. Its flexible clinical approach is founded on a therapeutic community (regarded as hub), residential interventions and home care. The personalized rehabilitation treatment plans take into consideration the different needs of each patient.
Keywords: Addiction, personality disorders, dual diagnosis, integration, innovation, adult psychiatry.
Marco Begarani, Silvia Codeluppi, Maristella Miglioli, A novel organization for the improvement of the clinical integration between Addiction Services, Adult Psychiatry and a Therapeutic Community. An innovative experience carried out by the Mental Health Department of the Local Health Unit in Parma in "RIVISTA SPERIMENTALE DI FRENIATRIA" 1/2017, pp. 127-147, DOI:10.3280/RSF2017-001009