Skip to main content Accessibility help
×
Home
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 2
  • Print publication year: 2008
  • Online publication date: August 2009

20 - Home treatment and ‘hospitality’ within a comprehensive community mental health centre

from Section 4 - Variations and enhancements

Summary

In Trieste, Italy, intensive community management of crises is one element of the comprehensive service delivered by 24-hour community mental health centres (CMHCs). This chapter describes the local strategy for crisis intervention, which integrates crisis management into the work of these CMHCs, allowing maintenance of continuity of care and flexible access to a wide range of community interventions. Comparisons will be made between crisis care integrated in this way into a comprehensive community service and specialist teams, dedicated solely to the management of crises.

Trieste's mental health system: history and service structures

Trieste's service network was established in the 1970s (Bennett, 1985; Dell'Acqua and Cogliati Dezza, 1985) in order to replace the old psychiatric hospital with a radically different network of services. The hospital, which had 1200 beds in 1971, finally closed in 1980. Franco Basaglia, radical theorist and pioneer of deinstitutionalisation and community alternatives to institutions, worked in Trieste and initiated this system between 1971 and 1980 (Basaglia, 1987) and CMHCs are the central component. Today, the Trieste Mental Health Department serves a catchment area with 242 000 inhabitants. As well as four CMHCs, it has eight hospital beds, a rehabilitation and residential support service that provides 72 beds in small group homes, and a day centre where training programmes and workshops are available. It collaborates with 13 social firms run on a cooperative basis. Family and service user groups, clubs and recovery homes are also available.

Related content

Powered by UNSILO
REFERENCES
Basaglia, F. (1987). Madness/delirium. In Psychiatry Inside-out. Selected Writings of Franco Basaglia, ed. Scheper-Hughes, N. and Lowell, A.. New York: Columbia University Press, pp. 233–63.
Bennett, D. H. (1985). The changing pattern of mental health care in Trieste. International Journal of Mental Health, 14, 7–92.
Dell'Acqua, G. and Cogliati Dezza, M. G. (1985). The end of the mental hospital: a review of the psychiatric experience in Trieste. Acta Psychiatrica ScandinavicaSupplement, 316, 45–69.
Dell'Acqua, G. and Mezzina, R. (1988a). Approaching mental distress. In Psychiatry in Transition. The British and Italian Experiences, ed. Ramon, S. and Giannichedda, M. G.. London: Pluto Press, pp. 60–71.
Dell'Acqua, G. and Mezzina, R. (1988b). Responding to crisis: strategies and intentionality in community psychiatric intervention. Per La Salute Mentale/For Mental Health, 1, 139–58.
Dell'Acqua, G., Belviso, D., Crusiz, C. and Oretti, A. (2003). Trieste e il suicidio: un progetto di prevenzione. Quaderni Italiani di Psichiatria, XXII, 11–23.
Katschnig, H. and Cooper, J. E. (1991). Psychiatric emergency and crisis intervention services. In Community Psychiatry. The Principles, ed. Bennett, D. H. and Freeman, H. L.. Edinburgh: Churchill Livingstone, pp. 517–42.
Mezzina, R. (2005). Paradigm shift in psychiatry: processes and outcomes. In Mental Health at the Crossroads: The Promise of the Psychosocial Approach, ed. Ramon, S. and Williams, J. E.. Aldershot, UK: Ashgate, pp. 81–93.
Mezzina, R. and Vidoni, D. (1995). Beyond the mental hospital: crisis intervention and continuity of care in Trieste. A four-year follow-up study in a community mental health centre. International Journal of Social Psychiatry, 41, 1–20.
Mezzina, R., Vidoni, D., Miceli, M.et al. (2005a). Crisi Psichiatrica e Sistemi Sanitari. Una Ricerca Italiana. Trieste: Asterios.
Mezzina, R., Vidoni, D., Miceli, M.et al. (2005b). Are 24 hours community crisis interventions evidence based? Indications from a multicentric longitudinal study. Psichiatria di Comunità, 4, 200–16.
Vicente, B., Vielma, M., Jenner, F. A., Mezzina, R. and Lliapas, I. (1993). Users' satisfaction with Mental Health Services. International Journal of Social Psychiatry, 39, 121–30.