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[南蒂罗尔的精神卫生保健]

[Mental healthcare in South Tyrol].

作者信息

Schaller Gerd, Pycha Roger, Conca Andreas, Steinert Tilman

机构信息

Psychiatrische Dienste Brixen, Brixen, Italien.

Psychiatrische Dienste Bozen, Bozen, Italien.

出版信息

Nervenarzt. 2025 Jul;96(4):355-361. doi: 10.1007/s00115-024-01755-w. Epub 2024 Oct 4.

Abstract

Mental healthcare in South Tyrol, as everywhere in Italy, is still characterized by Law 180, which came into force in 1978 under the leadership of Franco Basaglia and Bruno Orsini. The Ministry of Health subsequently set a target number of beds of 10/100,000 inhabitants. Unlike in other parts of Italy, private clinics play a minimal role in South Tyrol. The "Psychiatric Services" are part of the state healthcare system responsible for all citizens and are also responsible for compulsory outpatient care. According to the concept of community care, also due to the small number of inpatient beds, a great deal of care is provided on an outpatient basis. Coercive measures can only be used in the case of an illness requiring urgent treatment that the patient refuses, without recourse to endangering circumstances (self-endangerment or danger to a third party). Inpatient hospitalization is only possible if treatment also takes place and the principle of "outpatient before inpatient" also applies in this context, i.e., coercive treatment can only take place as an inpatient if it cannot be carried out as an outpatient. Forensic psychiatry has very few places and mentally ill offenders are often in prison or occupy beds in general psychiatric wards. Compared to Germany there are fewer beds available but staffing levels are better, particularly for nursing. In relation to the number of inhabitants, compulsory treatment is more frequent than in Germany, whereas involuntary hospitalization and physical restraint are much rarer (only possible in Italy by court order).

摘要

与意大利其他地方一样,南蒂罗尔的精神卫生保健仍以1978年在弗朗哥·巴萨利亚和布鲁诺·奥尔西尼领导下生效的第180号法律为特征。随后,卫生部设定了每10万居民10张床位的目标数量。与意大利其他地区不同,私立诊所在南蒂罗尔发挥的作用极小。“精神科服务”是国家医疗保健系统的一部分,负责所有公民,也负责强制门诊治疗。根据社区护理的理念,由于住院床位数量较少,大量护理是在门诊基础上提供的。只有在患者拒绝接受紧急治疗的疾病情况下,且不存在危及情况(自我伤害或对第三方造成危险)时,才可以采取强制措施。只有在进行治疗的情况下才可能进行住院治疗,“门诊优先于住院”的原则在此背景下也适用,即只有在无法作为门诊治疗时,才可以作为住院患者进行强制治疗。法医精神病学的床位非常少,患有精神疾病的罪犯通常被关押在监狱中,或者占用普通精神科病房的床位。与德国相比,可用床位较少,但人员配备水平较好,尤其是护理人员。就居民数量而言,强制治疗比德国更为频繁,而非自愿住院和身体约束则要少见得多(在意大利只有通过法院命令才可能实施)。

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