2023-04-25 12:31:53
The murder of Barbara Capovani, the psychiatrist attacked on Friday in front of the Pisa hospital by a former patient, brings back the theme of the reform of psychiatric assistance, which has remained at a standstill due to lack of resources, with structures in the area reduced to the bone , but also due to the lack of a legal framework of a penal nature which makes it possible to intervene on those who are violent.
From Opgs to Rems
After the Basaglia Law (the famous law 180), which turns 45 next May and which allowed the closure of asylums, there was a turning point in 2014 with the overcoming of judicial psychiatric hospitals (Opg), after the denunciation of their dramatic conditions . The creation of the Rems (Residences for Security Measures), residential health facilities with no more than 20 beds, were to represent the arrival of widespread and humanized assistance compared to the past but the tragedy of the psychiatrist killed by one of his former patients , demonstrates according to the doctors themselves, also the difficulties of these centers, emptied of resources and staff.
Another 10 thousand operators are needed
Another 10 thousand operators in mental health services would be needed, but the problem of safety, the experts point out, is above all legal. «After the closure of the asylums in 1978, the judicial psychiatric hospitals were closed a few years ago. Now there are Rems – explains Massimo Cozza, director of the mental health department of ASL Roma 2, among the heads of the departments who today launched a letter-appeal to the Government and to the President of the Republic Mattarella – but these structures are not suitable for everyone, especially for patients suffering from antisocial disorder, at risk of violent acts, as was the case with the man who killed the psychiatrist. These patients remain in the care of local services, in mental health departments, without them having the strength and conditions to deal with the outbreaks of violence. The request is to change the penal code, stuck at the Rocco Code of the 1930s. The proposal is to open some specialized sections in some prisons for patients with antisocial psychotic disorder who are guilty of crimes”.
The table convened by Minister Schillaci
Meanwhile, Health Minister Orazio Schillaci has called a new meeting for next Wednesday to resume work on psychiatry reform. «Over the past few months we have already begun to address the issue of mental health and the reform of procedures for assistance in psychiatric residential facilities. On Wednesday 26 April there will be a new meeting for the reorganization of the table on psychiatry. We must ensure that what happened to Barbara Capovani does not happen again », he said.
Requests from directors of mental health departments
For their part, the directors of the mental health departments are asking for “new tools, both on the health side and on the side of justice, without continuing to leave thousands of operators with their bare hands”. The Constitutional Court with sentence 22/2022, asked Parliament to intervene on this and the directors of the Mental Health Department themselves had issued a letter of appeal to the institutions to address the serious critical issues of territorial and hospital services. «Two requests are still unanswered to date. There is a need to review, after the proper closure of judicial psychiatric hospitals, the current critical situation of society’s responses to psychiatric patients who commit crimes, which is pouring problems, in particular on those who work in psychiatry wards and in the Rems relating to those people who have irrepressible aggressive manifestations that cannot be managed with only health initiatives “, write the directors.
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