Recent Developments in the Care, Treatment, and Rehabilitation of the Chronic Mentally Ill in Italy

Italy's mental health law of 1978 brought dramatic changes in mental health care to Italy by immediately closing large state hospitals to new patients. The law mandated a trend begun 20 years earlier by a group of professionals dedicated to dismantling large psychiatric hospitals. It is based on models developed by these professionals to move hospitalized patients into the community and to care for them through teams offormer hospital personnel working with local social agencies. In 1974, the professionals founded Democratic Psychiatry, a society whose aims included continuing to dismantle the hospitals. The work of the society and the provisions, problems, and successes of the mental health law are summarized. The author believes that valuable lessons can be learned from the gradualism inherent in the models used in devising the law and from the national health insurance support that implemented it.