Community Mental Health in Italy Today

Fioritti, Angelo; Amaddeo, Francesco

doi:10.1097/nmd.0000000000000139

Cited by 11 publications

(10 citation statements)

References 22 publications

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“…South Verona CMHS serves a catchment area of 108,421 inhabitants and is one of the four CMHSs constituting the Verona MHD. All three sites contain community mental health centres, day-hospital/day care rehabilitation centres, general hospital inpatient psychiatric units, and non-hospital residential care with medium- and long-term facilities, as required by Italian national mental health policy [ 27 ]. Since mental health services in the three sites share similar organizational features, the analysis considered the three centres together.…”

Section: Methodsmentioning

confidence: 99%

How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy

Cetrano

Tedeschi

Rabbi

et al. 2017

BMC Health Serv Res

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BackgroundQuality of working life includes elements such as autonomy, trust, ergonomics, participation, job complexity, and work-life balance. The overarching aim of this study was to investigate if and how quality of working life affects Compassion Fatigue, Burnout, and Compassion Satisfaction among mental health practitioners.MethodsStaff working in three Italian Mental Health Departments completed the Professional Quality of Life Scale, measuring Compassion Fatigue, Burnout, and Compassion Satisfaction, and the Quality of Working Life Questionnaire. The latter was used to collect socio-demographics, occupational characteristics and 13 indicators of quality of working life. Multiple regressions controlling for other variables were undertaken to predict Compassion Fatigue, Burnout, and Compassion Satisfaction.ResultsFour hundred questionnaires were completed. In bivariate analyses, experiencing more ergonomic problems, perceiving risks for the future, a higher impact of work on life, and lower levels of trust and of perceived quality of meetings were associated with poorer outcomes. Multivariate analysis showed that (a) ergonomic problems and impact of work on life predicted higher levels of both Compassion Fatigue and Burnout; (b) impact of life on work was associated with Compassion Fatigue and lower levels of trust and perceiving more risks for the future with Burnout only; (c) perceived quality of meetings, need of training, and perceiving no risks for the future predicted higher levels of Compassion Satisfaction.ConclusionsIn order to provide adequate mental health services, service providers need to give their employees adequate ergonomic conditions, giving special attention to time pressures. Building trustful relationships with management and within the teams is also crucial. Training and meetings are other important targets for potential improvement. Additionally, insecurity about the future should be addressed as it can affect both Burnout and Compassion Satisfaction. Finally, strategies to reduce possible work-life conflicts need to be considered.

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Section: Methodsmentioning

confidence: 99%

How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy

Cetrano

Tedeschi

Rabbi

et al. 2017

BMC Health Serv Res

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“…In Italy, the Law 833 (1978) and its following implementations protects the right of choosing and changing one's primary care physician and paediatrician, according to the principle of interpersonal trust. Despite a very long tradition of community-based mental health services (Fioritti & Amaddeo, 2014), where the PMHP is still the key figure to coordinate the contribution to care by different professionals, service users cannot generally choose their PMHP (Barbato et al, 2014). Only anecdotal reports exist that some Italian mental health centres have locally implemented operative instructions guiding how to manage users' request for choice and/or change of their PMHP (for example: Department of Bologna, Italy).…”

Section: Users' Choice Of Pmhp: National Health Policiesmentioning

confidence: 99%

Users’ choice and change of allocated primary mental health professional in community-based mental health services: A scoping review

Rioli

Ferrari

Henderson

et al. 2020

Int J Soc Psychiatry

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Background: The recovery model in mental health care emphasizes users’ right to be involved in key decisions of their care, including choice of one’s primary mental health professional (PMHP). Aims: The aim of this article was to provide a scoping review of the literature on the topic of users’ choice, request of change and preferences for the PMHP in community mental health services. Method: A search of the PubMed, Cochrane Library, Web of Science and PsycINFO for papers in English was performed. Additional relevant research articles were identified through the authors’ personal bibliography. Results: A total of 2,774 articles were screened and 38 papers were finally included. Four main aspects emerged: (1) the importance, for users, to be involved in the choice of their PMHP; (2) the importance, for users, of the continuity of care in the relationship with their PMHP; (3) factors of the user/PMHP dyad influencing users’ preferences; and (4) the effect of choice on the treatment outcomes. Conclusion: While it is generally agreed that it is important to consider users’ preferences in choosing or requesting to change their PMHP, little research on this topic is available. PMHPs’ and other stakeholders’ views should also be explored in order to discuss ethical and practical issues.

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“…Since the beginning, the Reform had a broad international impact, demonstrated by the number of monographs in international journals that saw to it in 40 years (Perris & Kemali, 1985;Mangen, 1989;Tansella & Burti, 1999;Fioritti & Amaddeo, 2014). However, it is difficult to draw any conclusive judgement about such a complex process, despite the increasing amount of literature attempting some empirical evaluation (de Girolamo et al 2007).…”

Section: Beyond the Borders: Implications Of The Italian Reform Outsimentioning

confidence: 99%

“…The picture emerging helps frame the puzzling differences in service provision along three major dimensions: (a) high-v. low-resources regional systems (basically a North-Central/South gap), (b) radical community v. balanced hospital/community systems, with Trieste and Lombardy at the two ends of the spectrum, and (c) 'generic' v. 'partially specialised' systems, with Campania and Emilia-Romagna at the two ends of the spectrum (Fioritti & Amaddeo, 2014;Lora et al 2014).…”

Section: What Really Happened In Italian Psychiatry In 1978?mentioning

confidence: 99%

Is freedom (still) therapy? The 40th anniversary of the Italian mental health care reform

Fioritti¹

2018

Epidemiol Psychiatr Sci

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On 13 May 1978, the Italian Parliament approved Law 180, universally known as ‘Basaglia Law’ after the name of the leader of the anti-institutional movement which promoted this radical community mental health care reform. Forty years later, Italian psychiatry still runs a community care system, albeit with degrees of solidity and quality very varied along the peninsula. Mental health care is still an integral part of the National Health System, with liberal regulations on coercion and a lowest number of general hospital and residential facilities beds. Recently, Italy has also closed the special forensic psychiatric institutions and brought the care of the mentally ill offenders within the responsibilities of local Mental Health Departments. Over time, psychiatric deinstitutionalisation inspired policies in other sectors of Italian society, such as those regarding physical and intellectual disabilities, education of children with special needs, drug addictions and management of deviant minors. Furthermore, debate about Law 180 has reached and maintained an international dimension, becoming a term of reference for international agencies such as the World Health Organization and the European Commission, for good and for evil. The overall balance sheet of the Reform process would seem mostly positive, though the last decade has seen many threats challenging the system. Mental health care services have been asked to do much more, in terms of care to a larger population with very diversified needs, but with much less resources, due to the financial consequences of the economic crisis. Although there is no evidence of a trend towards re-institutionalisation, intensity and quality of care may have fallen below acceptable standards in some parts of Italy.

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Community Mental Health in Italy Today

Cited by 11 publications

References 22 publications

How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy

How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy

Users’ choice and change of allocated primary mental health professional in community-based mental health services: A scoping review

Is freedom (still) therapy? The 40th anniversary of the Italian mental health care reform

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