Journal title PSICOTERAPIA E SCIENZE UMANE
Author/s Roberto Mezzina
Publishing Year 2023 Issue 2023/1 Language Italian
Pages 22 P. 37-58 File size 236 KB
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The issue of which services are necessary for a full enforcement of the Italian psychiatric reform of Law no. 180/1978, critical since its promulgation, is discussed starting from organizational models and institutional contexts of its application. They define the delivery of care as a comprehensive offer for a global alternative to the "asylum-like" institutional psychiatry, e.g., how to achieve not fragmented answers but a real "taking charge", with the active contribution of the per-son to his care, avoiding pathways of social and institutional drift. It is necessary not only to con-sider scientific evidence but also an ethical and value base that takes into account the experience and needs of patients. It is based upstream on cardinal cross-cutting principles as defined by the World Health Organization, among which the realization of human rights stands out, with the abandonment of coercive practices and involuntary treatments, the empowerment of patients, and a multisectoral approach to addressing the social determinants of health. From practice there are indications on the devices, i.e., the 24/7 opening and the continuity and non-fragmentation of care, and a series of basic indicators useful for benchmarking of organizational models of services. From international best practices derive a set of working principles as orientation points, without which the longed-for transition from tout-court psychiatry to community mental health remains unrealistic. Prospects for a paradigm shift, measurable through outcomes on people’s whole life, are outlined.
Keywords: Community Mental Health Centers; Italian Law no. 180/1978 on psy-chiatric reform; Ethics and evidence base; Human rights; Paradigm shift
Roberto Mezzina, Per una salute mentale di comunità: la questione dei Servizi e dei modelli in "PSICOTERAPIA E SCIENZE UMANE" 1/2023, pp 37-58, DOI: 10.3280/PU2023-001005