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

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Abstract

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.

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Authors and Affiliations

  1. Dept. of Mental Health, Azienda USL di Bologna, Viale Pepoli, 5, 40123, Bologna, Italy

    Giovanni de Girolamo

  2. Dept. of Mental Health, Azienda USL di Bologna, Bologna, Italy

    Giovanni de Girolamo & Mariano Bassi

  3. Dept. of Mental Health, Azienda USL di Modena, Modena, Italy

    Giovanni Neri

  4. Dept. of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy

    Mirella Ruggeri

  5. Psychiatric Clinic, United Hospitals of Ancona and Polytechnic University of Marche, Ancona, Italy

    Giovanni Santone

  6. Centre of Epidemiology, Health Surveillance and Promotion, Mental Health Unit, National Institute of Health, Rome, Italy

    Angelo Picardi

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  1. Giovanni de Girolamo
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  2. Mariano Bassi
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  3. Giovanni Neri
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  4. Mirella Ruggeri
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  5. Giovanni Santone
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  6. Angelo Picardi
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Correspondence to Giovanni de Girolamo.

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de Girolamo, G., Bassi, M., Neri, G. et al. The current state of mental health care in Italy: problems, perspectives, and lessons to learn. Eur Arch Psychiatry Clin Neurosci 257, 83–91 (2007). https://doi.org/10.1007/s00406-006-0695-x

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