Forensic psychiatric units in Italy from the 1960s to the present

Vito, Christian G. De

doi:10.1016/j.ijlp.2013.09.012

Cited by 13 publications

(5 citation statements)

References 2 publications

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“…Moreover, it provides complementary information for management decisions, the type of treatment and/or the most suitable facility (42). Finally, the Italian forensic psychiatric system and its recent reforms have been described extensively (2,43). However, the lack of studies supported by data is considered an eminent gap within the Italian system (5), and several authors stress the importance of systematically collecting data for service evaluation (1,44).…”

Section: Introductionmentioning

confidence: 99%

Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Vorstenbosch

Castelletti

2020

Front. Psychiatry

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The Italian forensic psychiatric system underwent drastic reforms. The newly developed facilities are inspired by psychiatric community services, embracing a recovery-oriented approach. Needs and quality of life are broader concepts that consider the more rehabilitative and humanitarian aspects of treatment. In one of the new Italian forensic psychiatric services, this cross-sectional study aimed to investigate the needs and quality of life of forensic psychiatric patients. A second aim was to validate the Italian version of the Forensic inpatient Quality of Life questionnaire Short Version (FQL-SV). Overall, 42 forensic psychiatric patients were assessed using the Forensic version of the Camberwell Assessment of Need (CANFOR), the Historical-Clinical-Risk-Management-20 (HCR-20), the FQL-SV, and the World Health Organization Quality of Life (WHOQoL-Bref). Patients reported significantly fewer needs, whether met or unmet, than their treating clinicians. The general level of agreement between patients and clinicians on specific needs was low Kappa values were < .40 for 64% of the total needs and 46% of the unmet needs. Risk factors according to the HCR-20 mean scores were 13.1, 4.6, and 6.4 for the historical, clinical and risk management subscale. Quality of life was moderate to high for 74% of the patients. Our results showed that lower numbers of needs, whether reported by patients or clinicians, were associated with a better quality of life. The Italian FQL-SV had a Cronbach's alpha of 0.86 and correlated as expected with the WHOQoL-Bref. The FQL-SV is a valid and reliable tool, justifying its use for routinely assessing QoL in Italian forensic psychiatric services. This study enhances our understanding of needs and quality of life of forensic psychiatric patients and how their assessment could have an additional value for recoveryoriented treatment in forensic psychiatry. Although the detained status of forensic patients imposes real limits on the capacity for autonomy and choice, incorporating the patient's perspective on decision-making processes, in relation to aspects of treatment, care, and daily life, may have benefits such as a better treatment adherence or therapeutic alliance. Future research should clarify how routinely assessing needs and quality of life can contribute to the recovery of these forensic psychiatric patients.

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Section: Introductionmentioning

confidence: 99%

Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Vorstenbosch

Castelletti

2020

Front. Psychiatry

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“…After the fall of fascism and the proclamation of the Republic in 1946, Italian forensic psychiatric law and practice remained mostly unaltered throughout the 1950s and 1960s (Babini, 2014). The administration of asylums, called Ospedali Psichiatrici Giudiziari (forensic psychiatric hospitals) (OPG) from 1975 onward, was retained by the Ministry of Justice, which maintained the traditional emphasis on containment over recovery (De Vito, 2014). The sole exception was represented by the OPG in Castiglione delle Stiviere (Mantua, Lombardy), which from the 1980s on employed health care staff and distinguished itself from the other OPG by its higher standards of quality (Calogero, Rivellini, & Stratico', 2012;Andreoli, 2002).…”

Section: Republican Years and The De-institutionalisation Movementmentioning

confidence: 99%

“…Through its organisation Psichatria Democratica (Democratic Psychiatry), the movement campaigned to de-legitimatise psychiatric institutions among mental health professionals and the public (De Vito, 2014). Its successes culminated in 1978 with the promulgation of the Psychiatric and Health Act, best known as Basaglia Law (Law 180/1978), which included directives for the prospective closure of mental hospitals nationwide.…”

Section: Republican Years and The De-institutionalisation Movementmentioning

confidence: 99%

“…Throughout the 1980s and 1990s, financial pressures made the inclusion of forensic psychiatric services in the SSN a low priority for the Ministry of Health. This led to further procrastination over the reform of the sector (De Vito, 2014).…”

Section: Republican Years and The De-institutionalisation Movementmentioning

confidence: 99%

“…In addition, Law 180 removed "social dangerousness" as criterion for referral to Italian mental health services for the first time, 75 years after its introduction in the Mental Health Law 36/1904.3.1.5. Towards the closure of forensic psychiatric hospitalsDespite the success in closing down general psychiatric hospitals, the six existing forensic psychiatric hospitals passed untouched by the reform, as they remained under the jurisdiction of the Ministry of Justice and separated from all other health services, which were by this time included in the new-born Servizio Sanitario Nazionale (SSN) (National Health Service)(De Vito, 2014).…”

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confidence: 99%

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The closing of forensic psychiatric hospitals in Italy: Determinants, current status and future perspectives. A scoping review

Lorito

Castelletti²,

Lega

et al. 2017

International Journal of Law and Psychiatry

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The closing down of Italian forensic psychiatric hospitals represented a fundamental step for human rights. Further work is required to improve the current service, including potential reforming of the penal code, improved referral/admission processes and consistent monitoring to reduce service inequality across regions. Further research is crucial to test the effectiveness of the Italian model of care against traditional ones.

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