Surviving without the asylum. An overview of the studies on the Italian reform movement.

In 1978, Italian Public Law No. 180 abandoned the mental hospital. This historic reform has generated considerable debate in Europe and the United States. Many critiques have forecasted catastrophic results; others have been extremely optimistic. However, few analyses have been based upon empirical research. This review summarizes all of the major empirical investigations evaluating the reform's outcome. The data support the conclusion that Italian society has successfully generated a psychiatric system without asylums. However, although psychiatrically disabled patients have been successfully shifted to community services, more effort is necessary in Italy to extend the reform to resource-poor regions as well as to the most debilitated patient groups.