Italy
Italy was the first country to begin the deinstitutionalisation of mental health care and to develop a community-based psychiatric system. From 1973 to 1996, psychoanalyst Giorgio Antonucci worked on the dismantling of the psychiatric hospitals “Osservanza” and “Luigi Lolli”, both in Imola (Bologna), and the liberation – and restitution to life – of the patients. In 1978, the Basaglia Law (“Law 180”)1 began psychiatric reform in Italy, eventually resulting in the end of the Italian state mental hospital system in 1998. The reform was focused on the gradual dismantling of psychiatric hospitals, which required an effective community mental health service. The object of community care was to interrupt the practice of isolating the mentally ill in large institutions and to promote their integration into a socially stimulating environment, while at the same time protecting them from excessive social pressure.
France
Since the 1960s, French public mental health services have been organised in “sectors”, each sector caring for an average population of 54,000 inhabitants.
The U.K.
In the United Kingdom, the trend for deinstitutionalisation began in the 1950s. Enoch Powell, the Minister of Health in the early 1960s, criticised psychiatric institutions and stated that mental health care should be transferred to general hospitals and the community. In the 1980s, Margaret Thatcher’s government began the Care in the Community initiative to reduce the number of mental hospitals.
The United States
The United States has experienced two phases of deinstitutionalisation. The first began in the 1950s and targeted people with mental illness. The second began nearly fifteen years later and focused on individuals who had been diagnosed with a developmental disability. Deinstitutionalisation continues, though the movements are growing smaller because fewer people are sent to institutions.1
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1 The main principle of Law 180 is that patients with mental disorders have the right to be treated the same way as patients with other diseases. This means that acute mental health conditions have to be managed in psychiatric wards locateci in generai hospitals. These wards cannot exceed 15 beds.
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1 Mental care is organised on a geographical basis in ............. .
France or USA?
