Violent Behavior in Forensic Residential Facilities: The Italian Experience After the Closure of Forensic Psychiatric Hospitals
The closing of six forensic psychiatric hospitals (OPG-Ospedali Psichiatrici Giudiziari) in Italy completed the long transition to a psychiatric community model of treatment. From 2014 to 2017, 20-bed, secure, community forensic residential facilities (REMS) were built and activated by regional health authorities in Italy, where people with mental disorders who committed a criminal offense, without criminal responsibility but still considered socially dangerous, must be treated. The REMS are health facilities where healthcare workers encourage inpatients to participate in a recovery-oriented rehabilitation project in order to return them to local services as soon as possible. Many difficulties obstruct the road to rehabilitation: interaction between the judicial and the healthcare sectors and among healthcare workers inside and outside the REMS; characteristics of the inmates and their level of collaboration; and lack of a penal code befitting the new situation. In this chapter, the authors describe the risks of violent behavior and the manner in which it must be avoided and managed in the two REMS of the Piedmont region. Following a request by the healthcare workers, an internal, unarmed guard was added to the staff. This guard participates in rehabilitation activities with the patients, reducing risk of injuries in the forensic residential facilities.
KeywordsViolence Mental disorders Forensic psychiatry Prison Residential Services for the Execution of Security Measures Criminal justice Prevention
The authors thank Marina Gentile and Antonella Maffioletti of the Health Regional Authority and Martina Ciminiello for technical editing.
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