The Italian experience in mental health care

Italy's Law 180, passed in 1978, abolished mental hospitals and replaced them with community services. The Italian literature suggests that the law has been far less successful in improving services for mental patients than reports by foreign visitors have indicated. The authors visited Italy on two occasions in 1984 and 1985 to assess for themselves the impact of the law. In many parts of the country hospitals were still open but badly understaffed and physically deteriorated; in Trieste, where the reform movement started, there was a good system of services, but a hospital whose closing had been publicly celebrated still housed several hundred patients. The authors describe the social and political climate in which Law 180 was passed, discuss the central role of Franco Basaglia and his Psichiatria Democratica movement, summarize the findings of their two visits, and attempt to explain why members of Psichiatria Democratica consider hospitals that remain open to be closed.