Lovell A M
Hosp Community Psychiatry. 1986 Aug;37(8):802-8. doi: 10.1176/ps.37.8.802.
Recent data on Italy's mental health law of 1978 delineate a more complex picture of deinstitutionalization than that suggested by the first wave of enthusiastic writings on the law's implementation. In violation of the law's original intent, many Italian regions depend heavily on newly established hospital-based units, while development of community services has been uneven. Factors affecting implementation include both ambiguous and unenforceable provisions in the law and unwillingness at the national and local levels to fund necessary community alternatives. Recent proposals to "reform the reform" may move Italian psychiatry even further away from the legacy of successful deinstitutionalization in cities such as Trieste and Arezzo.
近期有关意大利1978年精神卫生法的数据描绘了一幅比第一波关于该法实施的热情洋溢的著作所暗示的更为复杂的去机构化图景。许多意大利地区违背了该法的初衷，严重依赖新设立的医院单位，而社区服务的发展则参差不齐。影响实施的因素包括该法中模糊且无法执行的条款，以及国家和地方层面不愿为必要的社区替代方案提供资金。近期“改革改革”的提议可能会使意大利精神病学进一步背离的里雅斯特和阿雷佐等城市成功去机构化的遗产。
