Skip to main content

Advertisement

SpringerLink
Log in

How Does the Residential Care System Change? A Longitudinal Survey in a Large Region of Italy

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

To describe 5-year changes in the provision of Residential Facilities (RFs) in a large Italian Region and in the characteristics of their staffing and patients. 2000 census data of all RFs with >4 residential beds in the Emilia-Romagna Region were compared with 2005 census data. The number of residential beds increased from 3.1 per 10,000 inhabitants in 2000 to 4.1 per 10,000 inhabitants in 2005. The RFs operated by private non-profit associations increased at a greater rate than the number of NHS-operated facilities, and the percentage of non-qualified staff has also risen at a greater rate than that observed for qualified staff. The number of individuals with comorbid substance abuse increased from 2.1% in 2000 to 5.7% in 2005. Patient turnover rates were low in both 5-year periods. A process of new institutionalization might be taking place. Mental health care policy-makers should take these findings into account to enhance the planning of effective services, including RFs granting a satisfactory quality of life to patients with severe disorders requiring long-term, eventually unlimited care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Allen, H., Baigent, B., Kent, A., & Bolton, J. (1993). Rehabilitation and staffing levels in a ‘new look’ hospital-hostel. Psychological Medicine, 23, 203–211.

    Article  PubMed  CAS  Google Scholar 

  • Ball, R. A., Moore, E., & Kuipers, L. (1992). Expressed emotion in community care staff. A comparison of patient outcome in a nine month follow-up of two hostels. Social Psychiatry and Psychiatric Epidemiology, 27, 35–39.

    Article  PubMed  CAS  Google Scholar 

  • de Girolamo, G., Bassi, M., Neri, G., Ruggeri, M., Santone, G., & Picardi, A. (2007). The current state of mental health care in Italy: Problems, perspectives, and lessons to learn. European Archives of Psychiatry and Clinical Neuroscience, 257, 83–91.

    Article  PubMed  Google Scholar 

  • de Girolamo, G., Picardi, A., Micciolo, R., Falloon, I., Fioritti, A., & Morosini, P. (2002). Residential care in Italy. National survey of non-hospital facilities. British Journal of Psychiatry, 181, 220–225.

    Article  PubMed  Google Scholar 

  • de Girolamo, G., Picardi, A., Santone, G., Falloon, I., Morosini, P., Fioritti, A., et al. (2005). The severely mentally ill in residential facilities: A national survey in Italy. Psychological Medicine, 35, 421–431.

    Article  PubMed  Google Scholar 

  • Earls, M., & Nelson, G. (1988). The relationship between long-term psychiatric clients’ psychological well-being and their perceptions of housing and social support. American Journal of Community Psychology, 16, 279–293.

    Article  PubMed  CAS  Google Scholar 

  • Ferri, M., & Saponaro, A. (2005). Rapporto 2005 sulle dipendenze in Emilia-Romagna. Utenza e attività dei servizi per le tossicodipendenze dal 1991 al 2004. Osservatorio regionale sulle dipendenze.

  • Fioritti, A., Lo Russo, L., & Melega, V. (1997). Reform said or done? The case of Emilia-Romagna within the Italian psychiatric context. American Journal of Psychiatry, 154, 94–98.

    PubMed  CAS  Google Scholar 

  • Goldsmith, R. J. (1999). Overview of psychiatric comorbidity. Practical and theoretic considerations. Psychiatric Clinics of North America, 22, 331–349. ix.

    Article  PubMed  CAS  Google Scholar 

  • Gutkowski, S., Ginath, Y., & Guttmann, F. (1992). Improving psychiatric environments through minimal architectural change. Hospital & Community Psychiatry, 43, 920–923.

    CAS  Google Scholar 

  • Holmqvist, R. (2000). Associations between staff feelings toward patients and treatment outcome at psychiatric treatment homes. The Journal of Nervous and Mental Disease, 188, 366–371.

    Article  PubMed  CAS  Google Scholar 

  • Hull, J. T., & Thompson, J. C. (1981). Factors which contribute to normalization in residential facilities for the mentally ill. Community Mental Health Journal, 17, 107–113.

    Article  PubMed  CAS  Google Scholar 

  • Kruzich, J. M. (1985). Community integration of the mentally ill in residential facilities. American Journal of Community Psychology, 13, 553–564.

    Article  PubMed  CAS  Google Scholar 

  • Lelliott, P., Audini, B., Knapp, M., & Chisholm, D. (1996). The mental health residential care study: Classification of facilities and description of residents. British Journal of Psychiatry, 169, 139–147.

    Article  PubMed  CAS  Google Scholar 

  • Linn, M. W., Klett, C. J., & Caffey, E. M., Jr. (1980). Foster home characteristics and psychiatric patient outcome. The wisdom of Gheel confirmed. Archives of General Psychiatry, 37, 129–132.

    PubMed  CAS  Google Scholar 

  • Lucca, A. M., & Allen, G. J. (2001). A statewide assessment of psychosocial rehabilitation programs: General characteristics and services. Psychiatric Rehabilitation Journal, 24, 205–213.

    PubMed  CAS  Google Scholar 

  • Macry, P. (1997). Rethinking a stereotype: Territorial differences and family models in the modernization of Italy. Journal of Modern Italian Studies, 2, 188–215.

    Google Scholar 

  • Moos, R. H. (1996). Understanding environments: The key to improving social processes and program outcomes. American Journal of Community Psychology, 24, 193–201.

    Article  PubMed  CAS  Google Scholar 

  • Moos, R. H. (2002). The mystery of human context and coping: An unraveling of clues. American Journal of Community Psychology, 30, 67–88.

    Article  PubMed  Google Scholar 

  • Moos, R. H., & Lemke, S. (1980). Assessing the physical and architectural features of sheltered care settings. Journal of Gerontology, 35, 571–583.

    PubMed  CAS  Google Scholar 

  • Nagy, M. P., Fisher, G. A., & Tessler, R. C. (1988). Effects of facility characteristics on the social adjustment of mentally ill residents of board-and-care homes. Hospital & Community Psychiatry, 39, 1281–1286.

    CAS  Google Scholar 

  • Picardi, A., Rucci, P., de Girolamo, G., Santone, G., Borsetti, G., & Morosini, P. (2006). The quality of life of the mentally ill living in residential facilities: Findings from a national survey in Italy. European Archives of Psychiatry and Clinical Neuroscience, 256, 372–381.

    Article  PubMed  Google Scholar 

  • Priebe, S. (2004). Institutionalization revisited–with and without walls. Acta Psychiatrica Scandinavica, 110, 81–82.

    Article  PubMed  Google Scholar 

  • Priebe, S., Badesconyi, A., Fioritti, A., Hansson, L., Kilian, R., Torres-Gonzales, F., et al. (2005). Reinstitutionalisation in mental health care: Comparison of data on service provision from six European countries. British Medical Journal, 330, 123–126.

    Article  PubMed  Google Scholar 

  • Randolph, F. L., Ridgway, P., & Carling, P. J. (1991). Residential programs for persons with severe mental illness: A nationwide survey of state-affiliated agencies. Hospital & Community Psychiatry, 42, 1111–1115.

    CAS  Google Scholar 

  • Segal, S. P., & Kotler, P. L. (1993). Sheltered care residence: Ten-year personal outcomes. American Journal of Orthopsychiatry, 63, 80–91.

    Article  PubMed  CAS  Google Scholar 

  • Senn, V., Kendal, R., & Trieman, N. (1997). The TAPS project 38: Level of training and its availability to carers within group homes in a London district. Team for the assessment of psychiatric services. Social Psychiatry and Psychiatric Epidemiology, 32, 317–322.

    Article  PubMed  CAS  Google Scholar 

  • Timko, C. (1996). Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patients outcomes. American Journal of Community Psychology, 24, 173–192.

    Article  PubMed  CAS  Google Scholar 

  • Timko, C., & Moos, R. H. (1991). A typology of social climates in group residential facilities for older people. Journal of Gerontology: Social Sciences, 46, S1160–S1169.

    Google Scholar 

  • Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., et al. (2003). Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. British Journal of Psychiatry, 183, 304–313.

    Article  PubMed  CAS  Google Scholar 

  • Whitehead, C. C., Polsky, R. H., Crookshank, C., & Fik, E. (1984). Objective and subjective evaluation of psychiatric ward redesign. American Journal of Psychiatry, 141, 639–644.

    PubMed  CAS  Google Scholar 

  • Younge, S. L., Oetting, E. R., Banning, J. H., & Younge, K. A. (1990). Psychological messages from the physical environment: The drug and alcohol treatment center environment. International Journal of the Addictions, 25, 905–955.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mental Health, Azienda USL di Modena, via Emilia Ovest, 438/a, 41100, Modena, Italy

    Giovanni Neri

  2. Department of Mental Health, Azienda USL di Bologna, via Benni n.4, 40054, Budrio, Bo, Italy

    Francesca Guzzetta

  3. Service for Mental Health Services and Health Care in Prisons, Emilia-Romagna Region, Viale Aldo Moro 21, 40127, Bologna, Italy

    Linda Pazzi & Rossella Bignami

  4. Centre of Epidemiology Surveillance and Health Promotion, National Institute of Health, Mental Health Unit, Viale Regina Elena, 299, 00161, Rome, Italy

    Angelo Picardi

  5. IRCCS Centro S. Giovanni di Dio-Fatebenefratelli, via Pilastroni 4, 20125, Brescia, Italy

    Giovanni de Girolamo

Authors
  1. Giovanni Neri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesca Guzzetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda Pazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rossella Bignami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Angelo Picardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni de Girolamo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giovanni de Girolamo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Neri, G., Guzzetta, F., Pazzi, L. et al. How Does the Residential Care System Change? A Longitudinal Survey in a Large Region of Italy. Community Ment Health J 47, 201–208 (2011). https://doi.org/10.1007/s10597-010-9355-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-010-9355-8

KeyWords

Search

Navigation