Psychiatric Service of Bruneck (BZ), Spitalstrasse 11, 39031 Brunico/Bruneck, Italy.
Eur Arch Psychiatry Clin Neurosci. 2011 Nov;261 Suppl 2:S135-9. doi: 10.1007/s00406-011-0245-z. Epub 2011 Sep 10.
The Italian psychiatric reform of 1978 was one of the most radical attempts in history to abolish the practise of custodial psychiatry using legislation. The work of the charismatic reformer Franco Basaglia had four main objectives, which have taken more than 30 years to achieve. Although the creation of outpatient mental health centres and a reduction in involuntary commitments occurred rapidly, the expensive development of small acute psychiatric departments in general hospitals as an alternative to psychiatric hospitals was implemented very slowly. According to a national survey by the Italian Ministry of Health, in 2001, there were a total of 9,300 acute beds for all of Italy, of which as many as 4,000 were in private facilities. With 1.72 acute beds per 10,000 inhabitants, Italy has one of the lowest figures in Europe of psychiatric beds. However, Italy's apparent and often praised low bed requirement places a large burden on families. The implementation of the reform process was most delayed and occurred at its worst in South Tyrol, in North Italy. In an effort to achieve a modern and progressive community-based psychiatric service, in particular one with more specialised services, mental health providers in this region have examined German, Austrian and Swiss models of psychiatric practice.
1978 年的意大利精神病学改革是历史上最激进的尝试之一，试图通过立法废除监禁式精神病学实践。具有超凡魅力的改革者 Franco Basaglia 的工作有四个主要目标，这些目标花了 30 多年才实现。尽管迅速建立了门诊心理健康中心并减少了非自愿住院治疗，但在综合医院中昂贵地开发小型急性精神科病房作为精神病院的替代方案的速度非常缓慢。根据意大利卫生部的一项全国性调查，2001 年，意大利共有 9300 张急性病床，其中多达 4000 张在私人设施中。意大利每 10000 居民中有 1.72 张急性病床，是欧洲拥有精神病床位数最少的国家之一。然而，意大利明显且经常受到称赞的低病床需求给家庭带来了沉重的负担。改革进程的实施在意大利北部的南蒂罗尔地区最为拖延和糟糕。为了实现现代化和进步的以社区为基础的精神卫生服务，特别是提供更专业服务的精神卫生服务，该地区的精神卫生服务提供者研究了德国、奥地利和瑞士的精神病学实践模式。
