Abstract
The Italian psychiatric reform of 1978 was one of the most radical attempts in history to abolish the practise of custodial psychiatry using legislation. The work of the charismatic reformer Franco Basaglia had four main objectives, which have taken more than 30 years to achieve. Although the creation of outpatient mental health centres and a reduction in involuntary commitments occurred rapidly, the expensive development of small acute psychiatric departments in general hospitals as an alternative to psychiatric hospitals was implemented very slowly. According to a national survey by the Italian Ministry of Health, in 2001, there were a total of 9,300 acute beds for all of Italy, of which as many as 4,000 were in private facilities. With 1.72 acute beds per 10,000 inhabitants, Italy has one of the lowest figures in Europe of psychiatric beds. However, Italy’s apparent and often praised low bed requirement places a large burden on families. The implementation of the reform process was most delayed and occurred at its worst in South Tyrol, in North Italy. In an effort to achieve a modern and progressive community-based psychiatric service, in particular one with more specialised services, mental health providers in this region have examined German, Austrian and Swiss models of psychiatric practice.
Similar content being viewed by others
References
Burti L (2001) Italian psychiatric reform 20 plus years after. Acta Psychiatr Scand 104(Suppl 410):41–46
Cazzullo CL et al. (1991) The establishment, monitoring and evaluation of community care services. In: Freeman H, Henderson J (eds) Evaluation of Comprehensive care of the mentally Ill, Gaskell, pp 30–44
Altamura AC, Goodwin GM (2010) How law 180 in Italy has reshaped psychiatriy after 30 years: past attitudes, current trends and unmet needs. Br J Psychiatry 197(4):261–262
Finzen A (1987) Von der Psychiatrie-Enquete zur postmodernen Psychiatrie. Psychiat Praxis 14:35–40
Häfner H (2001) Hat Basaglia eine bessere Psychiatrie geschaffen? Zur Biografie der italienischen Psychoreform. Nervenarzt 72:485–486
De Girolamo G, Cozza M (2000) The Italian psychiatric reform. A 20-year perspective. Int J Law Psychiatry 23(3–4):197–214
Magliano L, Fiorillo A, De Rosa C, Malangone C, Maj M (2005) Family burden in long term diseases: a comparative study in schizophrenia vs. physical disorder. Soc Sci Med 61:313–322
Magliano L, Fiorillo A, Malangone C, De Rosa C, Maj M (2006) Implementation of family psychoeducational interventions for schizophrenia in mental health services: preliminary results from a multicentre Italian study. Psychiatric Serv 57:266–269
Bassi M et al (2003) Appendice. In: Bassi M, Di Giannantonio M, Ferrannini L et al (eds) Politiche sanitarie in psichiatria. Norme, management ed economia, Milano, pp 309–458
De Girolamo G, Polidori G, Morosini P, Scarpino V, Reda V, Serra G, Mazzi F, Alonso J, Vilagut G, Visonà G, Falsirollo F, Rossi A, Warner R (2006) Prevalence of common mental disorders in Italy. Results from the European Study of the epidemiology of mental disorders (ESEMeD). Soc Psychiatry Psychiatr Epidemiol 41:853–861
Wittchen HU, Jacobi F (2005) Size and burden of mental disorders in Europe: a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 15:357–376
Dalstra JA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G, Geurts JJM, Lahelma E, Van Oyen H, Rasmussen NK, Regidor E, Spadea T, Mackenbach JP (2005) Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol 28:316–326
Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, Bruffaerts R, De Girolamo G, De Graaf R, Gureje O, Harm JM, Karam EG, Kessler RC, Kovess V, Lane MC, Lee S, Levinson D, Ono Y, Petukhova M, Posada-Villa J, Seedat S, Wells JE (2007) Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 370(8):841–850
De Girolamo G, Barbato A, Bracco R, Gaddini A, Miglio R, Morosini P, Norcio B, Picardi A, Rossi E, Rucci P, Santone G, Dell’Acqua B (2007) Characteristics and activities of acute psychiatric in-patient facilities: natinal survey in Italy. Br J Psychiatry 191:170–177
De Girolamo G, Bassi M, Neri G, Ruggeri M, Santone G, Picardi A (2007) The current state of mental health care in Italy: problems, perspectives, and lessons to learn. Eur Arch Psychiatry Clin Neurosci 257:83–91
Cozza M, Laurita S, Napoletano GM, Provengano R (1995) L’assistenza psichiatrica in Italia. La normativa e la diffusione dei servizi sul territorio. Istituto Italiano di Medicina Sociale Editore, Roma:175–188
Hinterhuber H, Meise U (1994) Südtiroler Psychiatrie-Plan: 16
Beschluss der Südtiroler Landesregierung (1992) Nr 1794 vom 13, 4
Ein zeitgemäßes Betreuungsnetz für die psychisch Kranken, Beschluss der Südtiroler Landesregierung (1996) Nr 711:4–3
Link BG et al (2001) The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv 12:1621–1626
Schulze B, Angermeyer MC (2002) Perspektivenwechsel: Stigma aus der Sicht schizophren erkrankter, ihrer Angehörigen und von Mitarbeitern in der psychiatrischen Versorgung. Neuropsychiatrie 16(1+2):78–86
Pycha R, Conca A (2006) Psychiatrische Versorgung aus einer Hand: Das Beispiel Südtirol. Wiener Medizinische Wochenschrift 3/4:111–117
Conflict of interest
R Pycha, J. Schwitzer, D. Duffy, G. Giupponi declare that they have no conflict of interest. A. Conca has served as a consultant for Lilly, BMS, Pfizer and on the speakers’ bureau of Lilly, BMS, Astra Zeneca, Lundbeck, Italfarma and Janssen. He declares that he has no conflict of interest with this publication.
This supplement was not sponsored by outside commercial interests. It was funded by the German Association for Psychiatry and Psychotherapy (DGPPN).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pycha, R., Giupponi, G., Schwitzer, J. et al. Italian psychiatric reform 1978: milestones for Italy and Europe in 2010?. Eur Arch Psychiatry Clin Neurosci 261 (Suppl 2), 135 (2011). https://doi.org/10.1007/s00406-011-0245-z
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s00406-011-0245-z