Serviço de Psiquiatria do Hospital Prof. Dr. Fernando Fonseca, E.P.E.
Abstract
Italian psychiatry has gained International attention
after its radical reform of 1978, which
established the progressive closure of mental
hospitals and the establishment of community
services throughout the country. However it is
technically inappropriate to talk about Italian
psychiatry as the devolution process has
transferred to the regions all competences
about policy, planning and evaluating health
services. This explains the variety of “community
psychiatries” that can be found along the
peninsula and the reasons of interest that can
arise from their comparison.
The development of community psychiatry
in Emilia‑Romagna,
a region of 4 million
inhabitants in Northern Italy, has proceeded
through two partially overlapping phases of
deinstitutionalization (1978‑1997)
and development
of integrated mental health departments
(1990‑2008).
The analysis of raw data
about allocation of resources and professional
capital development give way to tentative comparisons
with the current Portuguese situation
of implementation of a similar reform.
In 2006 the regional Council launched a three
year project aimed at rethinking the welfare
system and the integration of social and health
services, considering the dramatic social and
demographic changes occurring in the region.
This project has implied also a three year process
of redrafting mental health policy finalised
in the Emilia‑Romagna
Mental Health Action
Plan 2009‑2011
approved by the council in March 2009. It basically follows two strategies:
integration of health and social services and
further qualification of health services. The former
is pursued through a reshaping of the planning
and commissioning bodies of both health
and social services, previously separated and
now merging. They are taking responsibility on
many issues related to mental health care, such
as prevention, mental health promotion, supported
employment, supported housing, subsidies,
self‑help.
The improvement of community
services is an objective to be achieved through
formal accreditation and quality assurance
mechanisms and through a widespread system
of participation of users and carers to all levels
of planning and monitoring
