Claudio Di Lorito1, Luca Castelletti2, Ilaria Lega3, Barbara Gualco4, Franco Scarpa5, Birgit Vӧllm6. 1. Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG7 2TU, United Kingdom. Electronic address: claudio.dilorito@nottingham.ac.uk. 2. REMS Nogara (VR), Aulss 9, Veneto Region 37054, Italy. 3. Italian National Institute of Health, Viale Regina Elena 299 - 00161, Rome, Italy. 4. Department of Health Sciences, University of Firenze, Largo Brambilla 3, 50134 Firenze, Italy. 5. Local Health Unit Centre of Toscana, Viale della Piazzuola 56, 50133 Firenze, Italy. 6. Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG7 2TU, United Kingdom.
Abstract
INTRODUCTION: Italy is the only country in the world to have closed forensic psychiatric hospitals and converted to fully-residential services. The international interest around this reform has not been matched by research. This scoping review aims to report the determinants of the reform, the most updated information on how the system operates, its benefits and its challenges. We further aim to discuss the implications for policy, research and practice. METHODS: 1. Selection of relevant sources through electronic search on four databases, Google, relevant printed materials and personal communication with practitioners currently working in REMS. 2. Study quality monitoring. 3. Data extraction onto NVivo 4. Data synthesis through content analysis. RESULTS: 43 papers were selected for inclusion in our review. Two main themes were identified: 1. Historical chronology of the closure of forensic psychiatric hospitals; 2. The current model of residential forensic psychiatric care. CONCLUSIONS: The closing down of Italian forensic psychiatric hospitals represented a fundamental step for human rights. Further work is required to improve the current service, including potential reforming of the penal code, improved referral/admission processes and consistent monitoring to reduce service inequality across regions. Further research is crucial to test the effectiveness of the Italian model of care against traditional ones.
INTRODUCTION: Italy is the only country in the world to have closed forensic psychiatric hospitals and converted to fully-residential services. The international interest around this reform has not been matched by research. This scoping review aims to report the determinants of the reform, the most updated information on how the system operates, its benefits and its challenges. We further aim to discuss the implications for policy, research and practice. METHODS: 1. Selection of relevant sources through electronic search on four databases, Google, relevant printed materials and personal communication with practitioners currently working in REMS. 2. Study quality monitoring. 3. Data extraction onto NVivo 4. Data synthesis through content analysis. RESULTS: 43 papers were selected for inclusion in our review. Two main themes were identified: 1. Historical chronology of the closure of forensic psychiatric hospitals; 2. The current model of residential forensic psychiatric care. CONCLUSIONS: The closing down of Italian forensic psychiatric hospitals represented a fundamental step for human rights. Further work is required to improve the current service, including potential reforming of the penal code, improved referral/admission processes and consistent monitoring to reduce service inequality across regions. Further research is crucial to test the effectiveness of the Italian model of care against traditional ones.
Authors: Giulio Di Mizio; Matteo Bolcato; Gianfranco Rivellini; Michele Di Nunzio; Valentina Falvo; Marco Nuti; Francesco Enrichens; Luciano Lucania; Nunzio Di Nunno; Massimo Clerici Journal: Int J Environ Res Public Health Date: 2022-08-12 Impact factor: 4.614