European Archives of Psychiatry and Clinical Neuroscience

, Volume 257, Issue 2, pp 83-91

First online:

The current state of mental health care in Italy: problems, perspectives, and lessons to learn

  • Giovanni de GirolamoAffiliated withDept. of Mental Health, Azienda USL di BolognaDept. of Mental Health, Azienda USL di Bologna Email author 
  • , Mariano BassiAffiliated withDept. of Mental Health, Azienda USL di Bologna
  • , Giovanni NeriAffiliated withDept. of Mental Health, Azienda USL di Modena
  • , Mirella RuggeriAffiliated withDept. of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona
  • , Giovanni SantoneAffiliated withPsychiatric Clinic, United Hospitals of Ancona and Polytechnic University of Marche
  • , Angelo PicardiAffiliated withCentre of Epidemiology, Health Surveillance and Promotion, Mental Health Unit, National Institute of Health

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After legislative changes in 1978, Italian psychiatry underwent a thorough overhaul, with the gradual closure of all Mental Hospitals. A nation-wide network of Departments of Mental Health now deliver outpatient and inpatient care, but also run semi-residential and residential facilities (the latter with 2.9 beds per 10,000 inhabitants). Hospital care is delivered through small psychiatric units (with no more than 15 beds). There are also many private inpatient facilities operating in Italy, and the number of private inpatient beds per 10,000 inhabitants exceeds the number of public beds; overall there are 1.7 acute beds per 10,000 inhabitants—one of Europe’s currently lowest numbers. There is marked quanti- and qualitative variation in the provision of out- and inpatient care throughout the country, and service utilization patterns are similarly uneven. Studies examining quality of life report a fairly high degree of patient satisfaction, whereas patients’ families frequently bear a heavy burden. In conclusion, the Italian reform law led to the establishment of a broad network of facilities to meet diverse care needs. Further efforts are required to improve quality of care and to develop a more effectively integrated system. Greater attention must be paid to topics such as quality of care and outcomes, public and private sector balance, and the coordination of various resources and agencies.


health services research mental health mental health services quality of care