Consortium PSYCHIATRICUMConsortium PSYCHIATRICUMConsortium PSYCHIATRICUM2712-76722713-2919Eco-Vector7610.17816/CP76SPECIAL ARTICLEСПЕЦИАЛЬНАЯ СТАТЬЯResearch ArticleCommunity Mental Health Services in ItalyВнебольничные службы охраны психического здоровья в ИталииSampognaGaiaСампоньяГайя
Italy
erasmusincoming@unicampania.itDel VecchioValeriaДель ВеккьоВалерия
Italy
erasmusincoming@unicampania.itDe RosaCorradoде РосаКоррадо
Italy
erasmusincoming@unicampania.itGiallonardoVincenzoДжаллонардоВинченцо
Italy
erasmusincoming@unicampania.itLucianoMarioЛучаноМарио
Italy
erasmusincoming@unicampania.itPalummoCarmelaПалуммоКармела
Italy
erasmusincoming@unicampania.itDi VincenzoMatteoДи ВинченцоМаттэо
Italy
erasmusincoming@unicampania.itFiorilloAndreaФиориллоАндреа
Italy
andrea.fiorillo@unicampania.itUniversity of Campania “Luigi Vanvitelli”Университета региона Кампания «Луиджи Ванвителли»250520212286922604202126042021Copyright ©; 2021, Sampogna G., Del Vecchio V., De Rosa C., Giallonardo V., Luciano M., Palummo C., Di Vincenzo M., Fiorillo A.Copyright ©; 2021, Сампонья Г., Дель Веккьо В., де Роса К., Джаллонардо В., Лучано М., Палуммо К., Ди Винченцо М., Фиорилло А.2021Sampogna G., Del Vecchio V., De Rosa C., Giallonardo V., Luciano M., Palummo C., Di Vincenzo M., Fiorillo A.Сампонья Г., Дель Веккьо В., де Роса К., Джаллонардо В., Лучано М., Палуммо К., Ди Винченцо М., Фиорилло А.https://creativecommons.org/licenses/by/4.0https://consortium-psy.com/jour/article/view/76

In 1978, in Italy, approval of Basaglia’s reform law marked a shift from an asylum-based to a community-based mental health system. The main aim of the reform was to treat patients in the community and no longer in psychiatric hospitals. Following the Italian model, similar reforms of mental health care have been approved worldwide. The community-based model aims to promote integration and human rights for people with mental disorders on the basis of their freedom to choose treatment options.

By 2000, all psychiatric hospitals had been closed and all patients discharged. Mental health care is organized through the Department of Mental Health, which is the umbrella organization responsible for specialist mental health care in the community; this includes psychiatric wards located in general hospitals, residential facilities, mental health centres, and day-hospital and day-care units.

Approval of Law 180 led to a practical and ideological shift in the provision of care to patients with mental disorders. In particular, the reform highlighted the need to treat patients in the same way as any other patient, and mental health care moved from a custodialistic to a therapeutic model.

Progressive consolidation of the community-based system of mental health care in Italy has been observed in the past 40 years. However, some reasons for concern still exist, including low staffing levels, potential use of community residential facilities as long-stay residential services, and a heterogeneity in the availability of resources for mental health throughout the country.

В 1978 году в Италии принятие Закона Базальи, предусматривающего реформу психиатрии, ознаменовал переход от стационарной к внебольничной системе оказания помощи в области охраны психического здоровья. Основная цель реформы состояла в том, чтобы пациенты получали лечение по месту жительства, а не в психиатрических больницах. Следуя итальянской модели, аналогичные системы оказания психиатрической помощи получили широкое распространение в мире. Внебольничная модель оказания помощи ориентирована на содействие интеграции в общество и соблюдение прав человека в отношении лиц с психическими расстройствами, т.к. она предусматривает свободу выбора пациентами вида лечения.

К 2000 году все психиатрические больницы были закрыты, а все пациенты выписаны. Психиатрическая помощь осуществляется через Департамент психического здоровья, который является головной организацией, отвечающей за соответствующую специализированную помощь по территориальному принципу; сюда входят психиатрические отделения, открытые в больницах общего профиля, учреждения интернатного типа, центры психического здоровья, дневные стационары и отделения дневного пребывания.

Принятие Закона 180 привело к практическому и идеологическому сдвигу в том, что касается оказания помощи пациентам с психическими расстройствами. В частности, реформа подчеркнула необходимость лечить такого рода пациентов так же, как и любого другого пациента, а психиатрическая служба перешла от модели, предусматривающей оказание помощи в закрытом учреждении (недобровольная госпитализация), к модели терапевтической.

В Италии на протяжении последних 40 лет наблюдается последовательное совершенствование внебольничной психиатрической помощи. Однако некоторые причины для беспокойства все еще существуют, в том числе недостаточная укомплектованность персоналом, потенциальное использование общественных жилых объектов для долговременного проживания, а также неравномерность доступности ресурсов, обеспечивающих психическое здоровье, применительно ко всей стране.

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