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Italian psychiatric reform 20 plus years after
1Department of Medicine and Public Health, University of Verona, Italy. lorenzo.burti@univr.it
Objective:
To describe the current situation of mental health care in Italy and implementation of mental health reform legislation.
Method:
The current mental health care system and studies of the implementation of psychiatric reform are described.
Results:
The 1978 reform law inaugurated fundamental changes in the care system (prohibiting admissions to state mental hospitals, stipulating community-based services, allowing hospitalization only in small general-hospital units). Uneven reform implementation was reported initially. However, in 1984 in- and out-patient services in the community were available to >80% of the population. There is a comprehensive network of in- and out-patient, residential and semi-residential facilities. Recently, services have been jeopardized by the managed-care revolution, and non-profit organizations supplement the public system (especially residential care, employment and self/mutual help).
Conclusion:
Implementation of the psychiatric reform law has been accomplished, and the year 1998 marked the very end of the state mental hospital system in Italy.