Thirtieth Birthday Of The Italian Psychiatric Reform: Research For Identifying Its Active Ingredients Is Urgently Needed

摘要

In 2008 Italian psychiatry celebrates 30 years since the passing of Italian Law Number 180, the reform law that marked the phasing out of psychiatric hospitals and the gradual development of a community-based system of psychiatric care. After 30 years of implementation, Law 180 is still unique in the international scenario, considering that Italy remains the only country in the world where traditional mental hospitals are outside of the law. Italian psychiatric reform has been criticised over the years, and it is still difficult to make a fair judgement. It is nevertheless possible, after 30 years, to highlight the main long-term consequences of its implementation in terms of psychiatric resource availability and use. The first consequence of Law 180 is that patients who were living in psychiatric hospitals before 1978 were placed progressively into the community. From 1978 to 1987 the inpatient population dropped by 53% and the final dismantling of psychiatric hospitals had been completed by 2000. A second consequence is that the availability of psychiatric beds in Italy is lower than in other comparable countries. For every 100 000 inhabitants Italy has 46 psychiatric beds, compared with 58 in the UK and 77 in the USA.