Forty years after the psychiatric reform in Italy (Law no. 180/1978), the author, who co-signed a proposal for a reform of this Law (proposal no. 656 of 2018, first signer Senator Marin), examines the critical elements of the total deinstitutionalization implemented in Italy. The current situation is not related to the failure of implementing the reform, but rather it is the consequence of the ideas of Franco Basaglia, who inspired the reform although he was ambivalent about it. If utopian elements accompanied the birth of asylums, in Italy the utopia was even more relevant in determining their closing. The Italian psychiatric reform of 1978 represented a compromise: the Law no. 180/1978 established small psychiatric units for emergencies in general hospitals. The motto of Tancredi Falconeri, nephew of the Prince of Salina in Giuseppe Tomasi di Lampedusa’s 1958 novel The Leopard - «If we want things to stay as they are, things will have to change» - has characterized the choices of the leading group of Italian psychiatrists: with the Law no. 180/1978 they obtained psychiatric units in the General Hospitals at the price of the renunciation of psychiatric institutions for severe disorders. Today Italian psychiatrists are burdened by significant professional responsibilities, without any operational conditions that allow psychotic patients to be treated for the necessary length of hospital care.
Keywords: Italian Law no. 180/1978; Proposal of psychiatric reform; Chronicity; Anti-psychiatry; Psychiatric institution