Psichiatria democratica: a case study of an Italian community mental health service

The Italian Mental Health Act of 1978 signified a major reform of the psychiatric system in that country and included directives for the closing down of all mental hospitals. This paper reports the structure and mode of work of the newly created community mental health services in a Tuscan town. It further investigates the background that made such a major change possible, and details its successes and problems to date. In addition, the relevance of the Italian experience to policy changes in other national psychiatric systems which so far have been unable to produce a comprehensive community-centered service is discussed.