Italy is the first country to shut down all state psychiatric hospitals. In 1978, Italy enacted Law 180 that began the gradual dismantling of its mental hospitals. The leader of this movement was psychiatrist Franco Basaglia (1924-1980), superintendent of the San Gabriel mental hospital in Trieste at the time. A significant figure in the history of psychiatric rehabilitation, Basaglia is both hailed as a modern-day Phillipe Pinel and castigated as a hopelessly impratical ideologue. Italian psychiatric witnessed dramatic changes as a result of Basaglia’s work. Another result is the innovation of work cooperatives run by and for individuals with psychiatric disabilities all around Italy which have become heralded as models for social enterprise.
The legacy of Dr. Franco Basaglia is an important topic for psychiatric rehabilitation. It represents an example of a world without state mental hospitals. It has also been the catalyst of a whole new modality of self-directed employment by and for individuals with psychiatric disabilities as a major contributor to recovery. For this Special Topic in Psychiatric Rehabilitation, below is a suggested reading list about Basaglia, the changes he wrought in Italian psychiatry, and the social enterprise movement spawned by Italy’s deinstitutionalization.
Basaglia, F. (1964). The Destruction of the Mental Hospital as a Place of Institutionalisation: Thoughts Caused by Personal Experience with the Open Door System and Part Time Service. First international congress of social Psychiatry London 1964.
Burti, L. (2001). Italian Psychiatric Reform 20 Plus Years After. Acta Psychiatrica Scandinavica, 104, 41-46. doi: 10.1034/j.1600-0447.2001.1040s2041.x
Defourny, J., & Nyssens, M. . (2008). Social Enterprise in Europe–Recent Trends and Developments. Social Enterprise Journal, 4(3), 202.
Dell’Acqua, G., & Mezzina, R. (1998). Shouldering The Burden (Providing Treatment) for Persons with Schizophrenic Disturbances in the Community: The Deinstitutionalized Model. Schizophrenia Treatment Consensus Conference. Brussels, Belgium: Trieste Department of Mental Health.
De Girolamo, G., Barale, F., Politi, P., & Fusar-Poli, P. (2008). Franco Basaglia, 1924-1980. Am J Psychiatry, 165(8), 968-. doi: 10.1176/appi.ajp.2008.07111761
De Girolamo, G., Bassi, M., Neri, G., Ruggeri, M., Santone, G., & Picardi, A. (2007). The current state of mental health care in Italy: Problems, Perspectives, and Lessons to Learn. European Archives of Psychiatry & Clinical Neuroscience, 257(2), 83-91. doi: 10.1007/s00406-006-0695-x
Ducci, G., Stentella, C., & Vulterini, P. (2002). The Social Enterprise in Europe. International Journal of Mental Health, 31(3), 76-91.
Kendall, T. (1996). Trieste: The Current Situation. In Third International Conference on Psychosis: Integrating the Inner and Outer Worlds, University of Essex, Colchester, England, September 1996. Sponsored by The Guild of Psychotherapists, The Human Nature Trust, N. E. Essex Mental Health Trust, Centre for Psychoanalytic Studies, University of Essex.
Mezzina, R., & Vidoni, D. (1995). Beyond the Mental Hospital: Crisis Intervention and the Continuity of Care in Trieste. International Journal of Social Psychiatry, 41(1), 1-20. doi: 10.1177/002076409504100101
Norcio, B., Baldi, C., Dell’Acqua, G., & Marsilii, M. (2001). The Trieste Mental Health Services: History, Context, Principles
Piccinelli, M., Politi, P., & Barale, F. (2002). Focus on Psychiatry in Italy. The British Journal of Psychiatry, 181. 538-544.
Rotelli, F. (2001). Opening Address to the WAPR Congress, Paris, May 8, 2001. [Report on the status of Italy’s hospitalization system 20 years after its landmark law. by the successor to Dr. Franco Basaglia in Trieste]
Rotelli, F., Mezzina, R., DeLeonardis, O,. Goergen, R., & Evaristo, P. (n.d.). Is Rehabilitation A Social Enterprise? Trieste Mental Health Department. Trieste, Italy. Retrieved from http://www.triestesalutementale.it/english/doc/rotelli-et-al_xxxx_rehabilitation.pdf
Russo, G., & Carelli, F. (2009). Dismantling asylums: The Italian Job. London Journal of Primary Care.
Savio M., R., A. (1993). Cooperatives as a Social Enterprise in Italy: A Place for Social Integration and Rehabilitation. Acta Psychiatrica Scandinavica, 88, 238-242.
Thomas, A. (2004). The Rise of Social Cooperatives in Italy. Voluntas, 15(3), 243-263. doi: DOI: 10.1023/B:VOLU.0000046280.06580.d8
Trieste (Italy) Mental Health Department. Trieste: History of a Transformation, from http://www.triestesalutementale.it/english/mhd_history.htm