Community mental health in Italy today

摘要

In 1950, the American Journal of Psychiatry published "A Survey of Italian Psychiatry, 1949" by two authoritative psychiatrists, one American and the other one Italian (Lemkau and De Sanctis, 1950). It was a dramatic report on the obsolete and repressive institutions in Italy that were basically concerned with social control of deviant behavior. Some 30 years later, the passing of a reform law in 1978 ("Law 180") radically changed the scenario of psychiatric care in Italy. The reform made a broad international impact, demonstrated by the numerous articles and monographs in international journals, which ranged in tone from enthusiastic to disparaging (Jones et al., 1991; Mangen, 1989; Mosher, 1982; Perris and Kemali, 1985). Several foreign observers showed a deep interest in the numerous pilot experiences carried out in Italy before and after the reform (Bollini and Mollica, 1989); others noted the striking differences in the working models and the achievements observed across the country (Jones and Poletti, 1986; Saraceno and Tognoni, 1989). Some judged the Italian psychiatric situation to be "patchy and confused" (Freeman et al., 1985). Even today, Italian psychiatry is probably more debated than understood, despite the increasing amount of literature attempting some empirical evaluation (de Girolamo et aL, 2007; Fioritti et al., 1997).