The Italian mental health care is based on Law it. Legge , also called Legge Basaglia, from the name of the author of the reform, Franco Basaglia. It was adopted on May 13th The new legislation resulted from the actions of a strong anti-psychiatric movement and it brought about a major change in the organization of psychiatric care. The reform and its consequences were widely studied by the researchers, especially in the United Kingdom and the United States of America.
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On May the 13th, Law n. This law imposed the closure of mental hospitals and established public mental health services. The struggle that Basaglia and his colleagues, friends and pupils made, was not only a way of restoring dignity to the mentally ill.
It also freed them from imprisonment, stigma and from continuous and progressive denial of their identities. As Irving Goffmann once said it was also a revolution at the level of health institutions as it was a new way of conceiving mental disorders. The environment around the patient could be a tool of care, since perhaps it was indeed the root of discomfort. The asylums of the time in Italy, as indeed all over the world, were inhabited by patients who had lost the hope of rehabilitation, but sometimes even those who had been put there by chance: children born to schizophrenic women and who had been diagnosed at three months to allow them to stay close to their mothers, but who then remained in that cursed place, without stimulation or education; elderly diabetic women whose children had emigrated and had stayed away; people who accidentally stumbled into unfortunate encounters with policemen who misunderstood their intentions and died there by accident.
There were just some of the guests whose presence in that infamous place shocked me, on top of the many perturbing patients who showed the mystery of a self-closed in retreat. Many young doctors had begun their training under the enthusiastic drive of a reform that was not only a health intervention, but above all a revolutionary way of thinking and thinking about one another.
Psychiatry had become a political fact. In , in the atrium of a hospital in Ferrara, Italy. Psychiatric wards and services were animated by passion, but the above point of view was often refused and the technique looked at it with caution.
The Technique for some was also psychoanalysis, which at the time was mostly centred on the intra-psychic and the conception of an "opaque mirror" analyst. However, under this banner there was a lot of work, but also idealization and even fanaticism. He then continued with a series of criticisms of psychoanalysis, its cost, its massive presence on the level of the culture of newspapers and the press in general. The psychoanalysis of which Tranchina was talking at the time was certainly not the current one, which progressively unfortunately came out of universities and many health institutions and is not very present in the press, with a few exceptions.
In short, the challenge at the time was how to find a psychoanalysis that was more openly social. Many psychoanalysts, as well as many psychiatrists and then psychologists, nurses, porters, were to get involved in the work and create an impressive movement.
After the first "heroic" period, there progressively arrived a more balanced dimension characterized by an important group involvement within the institutions, with articulated supervision and accurate work within teams. The training of the operators was imposed as an instrument to care for the patient and his suffering and in parallel, alongside the individual intervention and pharmacological support, attention was drawn to the context in which the patient was born, formed and lived.
The work with mental suffering, and especially with psychosis, stimulated the psychoanalysts of those years and brought about changes in them, as well as work in the developmental age with children and adolescents.
Today, Basaglia law is being called into question, but it left an important and indelible sign in our culture. Promulgation of both this law and law n. Law is the first and only law which obliged the closing of asylums and regulated the Involuntary Psychiatric Treatment by establishing Public Mental Health Services. Italy was the first country in the world to dismantle Psychiatric Hospitals. Since Basaglia committed himself to reform the inpatient psychiatric care proposing to overcome the logic of asylums.
As early as calls for a less violent treatment of mentally ill people were proposed all over the world. To a large extent it represented the libertarian and anti-institutional movement that in those years was evolving all over the world.
Having personally taken part, during the years of my psychoanalytic training, to the process of deinstitutionalisation of the Arezzo Psychiatric Hospital and setting up of the territory community Mental Health Services, I can comment as an insider the logic and limits of that experience and the reform that derived from it.
There is no doubt that such law represented a scientific and cultural breakthrough in the way mental illness was conceived and a significant condemnation of the basically violent treatment that was taken place in asylums. At the time this limited vision partially hindered the potential and fruitful collaboration between anti-institutional psychiatrists and those psychoanalysts who were greatly committed to the advancement of the political concept of psychoanalytic treatment. The psychoanalytic movement has always taken an interest in many arenas and institutions have often been a special observatory.
A specific worry regarding the structural alterations that could modify the cultural identity of psychoanalysis has arisen from this exchange. Even now it is difficult to distinguish between balanced caution in order to preserve identity and conservative stances which are expression of anxieties regarding change.
He made inventive interpretations about the existing socio-political configuration that turned out to be quite useful for understanding the way institutions function. Even though there has been a rich theoretical output on institutions and social issues, psychoanalysts have waited a long time before challenging with the task of applying their psychoanalytic knowledge about the human mind to the management of institutions.
Among the variety of possible approaches, it is important to differentiate the several levels of psychoanalytic contribution to psychiatric teams. Group supervisions is the most suitable area of work to get the mental health professionals close to the varied facets and different levels of competence of the psychoanalyst supervisor.
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Paolo Fonda Trieste.
Basaglia Law or Law Italian : Legge Basaglia, Legge is the Italian Mental Health Act of which signified a large reform of the psychiatric system in Italy , contained directives for the closing down of all psychiatric hospitals  and led to their gradual replacement with a whole range of community-based services, including settings for acute in-patient care. The law itself lasted until December 23, Then, its articles were incorporated, with very little changes, into a broader law Italian : legge 23 dicembre , n. The new Italian law was created after conducting the long-term pilot experiments of deinstitutionalization in a number of cities including Gorizia , Arezzo , Trieste , Perugia , Ferrara between and
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