The Closure of Forensic Psychiatric Institutions in Italy
This chapter describes the legislative, organizational, and clinical innovations supporting the national and regional plan of closing the six Italian forensic hospitals. We illustrate the historical determinants of the contemporary situation, shedding light on the cultural heritage that has preserved the previous hospital-based system. The asylum organization had remained unchanged throughout the reformist period in the last decades, as correctional and general mental health sectors were totally separated in their organization.
Though the closure of forensic hospitals was first recommended by government in 2008, it has only been executed from 2014 onward. Forensic hospitals have been substituted by an alternative network of residential care, SSN (Sistema Sanitario Nazionale, National Health System) based, facilities called REMS – Residencies for the Application of Security Measures. The structural and functional characteristics of these facilities are defined by the law and are aimed at assuring general security, individual care, rehabilitation programs in a community environment, and small-scale dimensions, as the maximum capacity is fixed at 20 beds each. This chapter details the different phases of this ongoing process and the difficulties faced along the path, which are to be expected given the complexity of organizing a new system capable of working effectively within a short period of time.
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