ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08509.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTA brief survey is given of the evolution of Italian psychiatric legislation. The following acts are examined: the 1904 law, stating that people affected by mental derangement must be kept in custody and treated in mental hospitals when they are dangerous to themselves or to others or create public scandal; the 1909 regulations, in which various aspects of mental hospital organization are dealt with; the 1968 law, sanctioning the institution of voluntary admission; the 1978 Reform Act. It is emphasized that the 1978 Italian mental health law is the only one, in the Western industrialized world, in which: 1) patient's dangerousness is not used as a criterion for commitment, and compulsory admission is restricted to therapeutic emergency cases; 2) it is established that compulsory admission of psychiatric patients must be implemented in general hospitals; 3) prolonged hospitalizations are discouraged, by stating that compulsory treatment should last as a rule seven days; 4) it is sanctioned the abolishment of mental hospitals. Moreover, stress is laid on the law's attention to community‐based facilities, described as the places in which preventive, therapeutic and rehabilitative interventions relevant to mental diseases should be implemented as a rul

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08510.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThe available information system in Italy does not allow to adequately evaluate the change in patterns of hospitalization that have taken place after the 1978 Mental Health Act came into force. There are huge differences among Northern and Southern Italy and inside these areas. On average, the reduction of public psychiatric hospitals activity had begun around 70′s. People living in these hospitals at the census day January 1st were about 75,000 in the first years of the 70′s, were 58,000 in 1977 and further decreased to 38,000 in 1981 (67.6 per 100,000 total population). This decrease was not counterbalanced either by private psychiatric hospitals, or by the newly opened Psychiatric Departments in general hospitals. Scant or no information is available on intermediate facilities, and on follow‐up of discharged inpat

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08511.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThis paper describes the closing of the mental hospital in Trieste and the establishing of a comprehensive community mental health service, over a period of 13 years from 1971. In 1971 the hospital had 1058 patients. By 1975 there were 656 patients, 403 of whom were guests, in effect ordinary citizens who had nowhere else to live. The paper describes this dramatic and innovative transformation, the rearrangement of wards, the abolition of shock therapies, the establishment of many flats and group homes, the starting of a cleaning cooperative employing ex‐patients to do the work they previously did as “ergotherapy”, the first mass exodus of the patients into the city.The paper goes on to describe the opening of 7 mental health centres between 1975 and 1977 and the present existing network of services. At this time the hospital buildings were converted into a variety of uses for the benefit of the local people.It describes in greater detail the philosophy and practice of one of these centres at Barcola and how the dialectical relationship between staff and client works to create a flexible and responsive service.It ends by repeating the assertion that the closure of the mental hospital is a first necessary step towards an improved mental health service for eve

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08512.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThe organization of psychiatric care in Verona prior to the new Italian Mental Health Act, and the organization of the new South‐Verona Community Psychiatric Service (CPS) implemented in 1978 after the approval of the new law, are described. Case‐register data for the period 1979‐1983 are also reported. To compare in‐patient care provided in South‐Verona after the Reform with that of the previous year, data on hospital admissions during 1977 were collected retrospectively. From 1977 to 1983 compulsory admissions have decreased by 67%, the average number of occupied beds per day and the average length of in‐patient stay have decreased by 34%, while the total rates of admission have increased by 4%. The long‐stay in‐patient rate, which was already considerably low in 1977 (48/100,000), is still decreasing slightly and no ≪new≫ long‐stay patients have accumulated in psychiatric institutions during the past three years. In South‐Verona most of the patients are treated outside the hospital and the same staff is responsible for in‐ as well as for out‐patient care (which includes domiciliary visits and day care), to ensure therapeutic continuity. Although it lacks some complementary facilities the South‐Verona CPS in its five years of experience has been able to bring into action the psychiatric refor

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08513.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTDescriptive statistics derived from four psychiatric case‐register areas are presented. Attrition numbers of long‐stay inpatients and the accumulation of high‐user patients in non‐residential facilities are discussed, with the aim of providing tentative suggestions for a more rational planning of services. Similarities and differences among various areas of Northern Italy are also de

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08514.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThe possibility of overcoming the Psychiatric Hospital with a single Community Service consisting of a network of territorial activities for the total population of a defined area is described. An evaluation is made from 1971 to 1983. Handicapped children are treated essentially in the family and normal educational structures. Diagnostic prevalence of more serious cases, modes of treatment, scholastic facilities and rejection of special schools are described. Work methods and community facilities, mean‐year incidence and one‐year prevalence of patients aged 15 + are examined. The latter convalidates priority towards serious risk situations. Specific rehabilitation and work‐reintegration are programmed for handicap and disability patients. Release of long‐stay psychiatric patients continues through alternative programmes with housing facilities. By 1985 the Psychiatric Hospital should close down. The population is treated by the C.M.H.S. when hospitalized in the General Hospital where no psychiatric ward exists. Crisis intervention, alternative treatment and hospitalization statistics are de

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08515.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThe present paper provides a synthetic account of the process of renewal and transformation of psychiatric care in Umbria, and, more specifically, in Perugia, in the last two decades. In the first part we attempt to show that the significance assigned to the normative aspect in the framework of psychiatric care in Italy has been excessive, particularly in the last few years. In the second, we try to give an account of the psychiatric work done in Umbria. We deal first with the period preceding the passing of Law no. 180 by the Italian Parliament; then we discuss the relationship between the new law and the processes in action; finally, we consider more recent problems concerning the attempts to promote a psychiatric counter‐reformation and the theory and practice of our wor

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08516.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTOne of the most patent inconsistencies in the application of the 1978 Psychiatric Reform Act in many areas of Southern Italy has resulted from the irrational choice, by regional governments, of the general hospitals in which Psychiatric Special Units had to be implemented, and from the inappropriate determination of territorial boundaries defining the competence of such Units. Thus, in the city of Naples, it was decided, in June 1978, to set up Psychiatric Special Units only in the two University Psychiatric Departments and in the Psychiatric Emergency Ward at S. Gennaro Hospital. These Unites, equipped with an overall number of 39 beds, were put in charge with the whole province of Naples (about three millions inhabitants). Quite arbitrarily, it was established that University Departments had to admit patients coming from the city of Naples and S. Gennaro Hospital those residing in the rest of the province. By an equally arbitrary choice, female patients from the city of Naples were entrusted to the University Department I and male patients to the Psychiatric Department II. In the following years, from 1979 to 1983, some additional Units were set up in general hospitals of the Naples province. Nonetheless, available beds have not exceeded the overall number of 69, and the catchment areas of the three pre‐existing Special Units have not been modified. The chaotic situation engendered by this incongruous application of the Reform Act is outlined, by means of an analysis of the requests for compulsory admission addressed to the Special Unit at the Psychiatric Department I of Naples University during the periods June 16, 1978 ‐ December 31, 1979 and June 16, 1982 ‐ December 31,

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08517.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTEighty‐five Italian and forty‐nine Swedish patients consecutively admitted for compulsory treatment to either an Italian or a Swedish psychiatric unit in selected areas of the two countries have participated in an exploratory study aimed at assessing the main characteristics of compulsory admitted patients, and in particular, the immediate reason for admission. The two series proved to be quite similar as concerns most sociodemographic variables, and as concerns clinical diagnosis and severity of the morbid condition at admission as measured by means of a rating scale. More Swedish than Italian patients lived alone when admitted to hospital, and for more of them the request for admission was made by other people than relatives, and a larger proportion of them was accompanied to the hospital by medical or social welfare personnel. In both series the largest proportion had a low educational level and belonged to the lower social groups. The same proportion in the two series had previous admissions. The most common reason for admission was “odd or improper behaviour” for the Swedish patients, and “feared or manifest dangerousness” for the Italian patients. The Italian patients remained at hospital on average half the time than the Swedi

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb08518.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY