40th birthday of the Italian Mental Health Law 180 – perception and reputation abroad, and a personal suggestion

Becker, Thomas; Fangerau, Heiner

doi:10.1017/s2045796017000658

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…Despite the importance of RFs in Italian community mental health care after the early reform of psychiatric hospitals (Basaglia, 1968 ; Becker and Fangerau, 2018 ), they have not been surveyed for approximately 20 years (Culbreth et al ., 2021 ). Furthermore, indeed the mission of Italian RFs to implement strategies aimed at developing rehabilitation activities oriented to the personal recovery ethos in order to increase personal daily life skills and well-being, and based on the real needs for care of residents (Junghan et al ., 2007 ; Grinshpoon et al ., 2008 ; Killaspy, 2016 ), no studies have investigated the association between needs for care and daily life activities in a sample of residents with SSD, in detail, using the ESM.…”

Section: Introductionmentioning

confidence: 99%

Needs for care of residents with schizophrenia spectrum disorders and association with daily activities and mood monitored with experience sampling method: the DIAPASON study

Martinelli

D'Addazio²,

Zamparini³

et al. 2023

Epidemiol Psychiatr Sci

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Aims Care needs represent an essential paradigm in planning residential facility (RF) interventions. However, possible disagreements between users and staff are critical issues in service delivery. The Experience Sampling Method (ESM) tracks experiences in the real world and real time. This study aimed to evaluate the care needs of patients with schizophrenia spectrum disorder (SSD) in RFs and its association with daily activities and mood monitored using the ESM. Methods As part of the DIAPASON project, 313 residents with SSD were recruited from 99 Italian RFs. Sociodemographic and clinical characteristics were recorded. Care needs, the severity of symptomatology and negative symptoms were assessed. Fifty-six residents were also assessed for 7 consecutive days using the mobile ESM. Descriptive, agreement, predictor and moderator analyses were conducted. Results The staff rated a higher number of total and met needs than service users (p < 0.001). Only a slight agreement between users and staff on unmet needs was found in self-care (k = 0.106) and information (k = 0.100) needs, while a moderate agreement was found in accommodation (k = 0.484), food (k = 0.406), childcare (k = 0.530), physical health (k = 0.470), telephone (k = 0.458) and transport (k = 0.425) needs. Older age (−0.15; p < 0.01), longer SSD diagnosis (−0.16; p < 0.01), higher collaboration (−0.16; p < 0.01) and lower symptomatology (−0.16; p < 0.01) decreased the number of unmet needs, while being a female (0.27; p < 0.05) and a shorter length of stay in an RF (0.54; p < 0.001) increased the number of unmet needs. A higher number of unmet needs was associated with a lower amount of time spent in leisure activities or reporting a positive mood: on the contrary, more unmet needs were associated with a greater amount of time spent in religious or non-productive activities. The associations between unmet needs rated by staff and users and momentary mood as assessed using the ESM were not moderated by the severity of symptomatology. Conclusions Although care needs are fundamental in planning residential activities aimed at recovery-oriented rehabilitation, RF interventions did not fully meet users' needs, and some disagreements on unmet needs between users and staff were reported. Further efforts are necessary to overcome Italian RF limits in delivering rehabilitative interventions defined by real users' needs to facilitate users' productivity and progress towards personal recovery.

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Section: Introductionmentioning

confidence: 99%

Needs for care of residents with schizophrenia spectrum disorders and association with daily activities and mood monitored with experience sampling method: the DIAPASON study

Martinelli

D'Addazio²,

Zamparini³

et al. 2023

Epidemiol Psychiatr Sci

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“…B. [16][17][18]). Die italienische Reform war, besonders an Standorten wie Gorizia/Görz (therapeutische Gemeinschaft, [1961][1962][1963][1964][1965][1966][1967][1968][1969] und Triest (Anstaltsschließung, Aufbau Gemeindepsychiatrie 1971-1979) von starken, breit rezipierten publizistischen, künstlerischen und kulturellen Initiativen geprägt, eindrucksvolle Werke der Fotokunst dokumentierten das Drama der Anstaltspsychiatrie, die Schließung der Anstalt in Triest wurde mit einem skulptural gestalteten Auszug aus der Anstalt (Marco Cavallo) begleitet.…”

Section: Psychiatriereform In Italienunclassified

“…Genau dieses ‚Fenster der Möglichkeit' haben Basaglia und andere genutzt. Nicht ohne Grund sind in diesem Zusammenhang und zum Verständnis der Entwicklung wiederholt die Beiträge Antonio Gramscis zu einer, der gesellschaftlichen und kulturellen Tradition und Situation Italiens ent-sprechenden, ‚Philosophie der Praxis' herangezogen worden [16]. Im verstehenden Zugang könnten wir schließlich die intellektuellkulturelle Verbindung italienischer Reform-(nicht Anti-) Psychiatrie mit europäischen Denktraditionen der Zeit anführen, nämlich mit: ▪ Michel Foucaults gegenaufklärerischen Thesen (das Aufgeklärte braucht den Wahnsinn und das Aufgeklärte setzt den Wahnsinn, der Wahnsinn ist also nicht einfach vom Himmel gefallen, sondern das Produkt vielfältiger (Macht-) Prozesse) sowie mit ▪ Theodor W. Adorno, der (ähnlich Foucault) darauf hinwies, dass es eben kein Zuhause gibt in einer Welt, die schon in ihrem Grund nie unschuldig war (die Aufklärung startet mit dem Mythos und schlägt ihrerseits in Mythologie zurück, indem sie alles erklärbar und greifbar macht, auch wenn es weder das eine noch das andere ist).…”

Section: Kontrast Großbritannien Vs Italien -Reformprozesse Verstehenunclassified

Vergangenheit verstehen hilft Zukunt denken: Psychiatrie-Reformgeschichte in Großbritannien und Italien

2022

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ZusammenfassungDie Psychiatriereformen Großbritanniens und Italiens wurden viel diskutiert. Kürzliche Publikationen erlauben eine vergleichende Reflektion. In England begann der Prozess früher, erfolgte kontinuierlich, in den letzten Jahrzehnten wurden die Komponenten Deinstitutionalisierung und gemeindepsychiatrische Ausrichtung durch Nutzerbeteiligung, Management, Evidenzbasierte Medizin und Leitlinien sowie Budgetkürzungen ergänzt. Die Paradigmen jeweiligen Regierungshandelns sind erkennbar. In Italien begann der Reformprozess später, verlief disruptiver, war durch Basaglia und eine poltisch-zeitgeschichtliche Konstellation geprägt. Die italienische Reform zeigt Kontinuität, Defizite werden diskutiert, die Reform hat sich historisch bewährt. Gemeinsamkeiten und Unterschiede (GB vs I) werden verdeutlicht, eine sozialgeschichtliche Einordnung wird vorgeschlagen, um psychiatrische Reformen als Teil von Vergesellschaftungsprozessen zu begreifen. Dies ist wichtig, um Allianzen zur Weiterentwicklung psychiatrischer Versorgung identifizieren und gestalten zu können.

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“…The Italian experience attracted international attention for its innovative aspects and helped achieve what was accomplished in other countries, but many problems remain for the implementation. 2 Sadly, the reform law established some general principles and indications but did not give detailed standards for service and staff provision and the quality of care is still a matter of dispute (often inadequate drug treatments, psychotherapeutic, psycho-educational and rehabilitation interventions not being available, inpatient admissions too short with high readmission rates). 3 Italian psychiatric services vary considerably from one geographic area to another.…”

Section: Introductionmentioning

confidence: 99%

Critical issues and opportunities of emergency psychiatry in Italian emergency departments

2019

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In Italy emergency physicians are the front line of care for patients with medical conditions such as trauma, heart attacks, strokes or psychiatric disorders. Triage represents the first clinical contact with the person to determine urgency of care, and includes initial risk assessment and determination of observation level. It is necessary to undertake mental health triage for all service users on entry to the Emergency Department (ED), alongside physical health triage. The recourse to emergency services for psychiatric complaints is increasing and ED providers are often the first contact a patient will have with psychiatric care. The organization of Italian EDs is constantly evolving under the pressure of various external forces (population aging, increasing use of new substances, immigration, choices of economic policy, and technological development). The psychiatric emergency service contact represents a key to addressing the presenting problem and it is a critical link for continuity of care. The management of psychiatric disorders is an evolving issue in Italy as in other countries. Research increasingly suggests the importance of specific training for EDs teams in order to provide appropriate handling in acute settings. Psychiatrists and ED physicians can – and should – play a fundamental role in promoting a targeted and shared training for emergency services to deal with crisis according to evidence-based medicine. Service organization, legal issues, safety, training and education are not well defined and established and still imply improvisation, while they deserve attention as fundamental prerequisite to implement specific treatment guidelines.

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40th birthday of the Italian Mental Health Law 180 – perception and reputation abroad, and a personal suggestion

Cited by 9 publications

References 19 publications

Needs for care of residents with schizophrenia spectrum disorders and association with daily activities and mood monitored with experience sampling method: the DIAPASON study

Needs for care of residents with schizophrenia spectrum disorders and association with daily activities and mood monitored with experience sampling method: the DIAPASON study

Vergangenheit verstehen hilft Zukunt denken: Psychiatrie-Reformgeschichte in Großbritannien und Italien

Critical issues and opportunities of emergency psychiatry in Italian emergency departments

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