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The area of mental health is directly affected by the pandemic and its consequences, for various reasons: 1-the pandemic triggered a global lockdown, with dramatic socioeconomic and therefore psychosocial implications; 2-mental health services, which treat by definition a fragile population from the psychological, biological and social points of view, have a complex organizational frame, and it was expected that this would be affected (or overwhelmed) by the pandemic; 3-mental health services should, at least in theory, be able to help guide public health policies when these involve a significant modification of individual behaviour. It was conducted a narrative review of the publications produced by European researchers in the period February-June 2020 and indexed in PubMed. A total of 34 papers were analyzed, which document the profound clinical, organizational and procedural changes introduced in mental health services following this exceptional and largely unforeseen planetary event.Among the main innovations recorded everywhere, the strong push towards the use of telemedicine techniques should be mentioned: however, these require an adequate critical evaluation, which highlights their possibilities, limits, advantages and disadvantages instead of simple triumphalist judgments. Furthermore, should be emphasized the scarcity of quantitative studies conducted in this period and the absence of studies aimed, for example, at exploring the consequences of prolonged and forced face-to-face contact between patients and family members with a high index of "expressed emotions".

This paper focuses on the integration between Mental Health Services and Primary Care in Italy, a topic that has been discussed for many years but still remains to be achieved nationwide. After a brief review of the scientific literature considering different models of integration, the experiences of three Italian Regions (Lombardy, Emilia-Romagna and Tuscany) are described and discussed, in order to detect different options to fulfill the needs of an adequate cooperation in this field of public health.

On May 13, 1978 the Italian Mental health act [Law 180] was approved, better known as the Basaglia law, named after of the psychiatrist who inspired it. It represents the basis of the Italian mental health legislation: the outdated custodial care in psychiatric hospitals was shifted away from mental hospitals to community mental health centres. Alternative community care restored dignity and rights to locked up people. After forty years, it is time to make an assessment. Has the revolution begun by Franco Basaglia really ended? A journey through different Italian health centres has been performed, from Friuli-Venezia Giulia, where the Basaglia's experience started, to Piedmont, where - in the small town of Collegno - the largest psychiatric hospital in Italy was located. This paper collects memories of those who experienced this revolution, testimonies of young patients and former residents, stories of doctors involved in the daily care. A journey made of experiences, passions, hopes, disillusionments, but above all rights.

Standard treatment provided by mental health services, mainly based on drug therapy and individual sessions, does not help patients to enhance their capacity to prevent and manage crises., Aim: This paper aims at examining the effectiveness of four group-based rehabilitative interventions carried out in the Acute Psychiatric Inpatient Ward and in the Department of Mental Health of Viterbo, Italy., Methods: The effectiveness of the four group-based interventions on patients and their relatives was evaluated in both inpatient and outpatient settings in terms of clinical efficacy, disease awareness, quality of life, and ability to cope with stress. A set of specific assessment tools was used for the purpose., Results: Group-based interventions showed high level of effectiveness in improving patients' insight, clinical stability, quality of life and satisfaction in using the services, and in enhancing family members' ability to manage stress., Conclusions: Group-based rehabilitative interventions enable mental health services to provide users with additional treatment options complementary to drug therapy, improving the quality of life of patients and their families in a recovery-oriented perspective.

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Giovanni Jervis, was one of the protagonist of the Italian psychiatric reform and was greatly involved in all the phases of its development, but, with his typical intellectual rigours, he was also very critical not toward the law 180 which abolished the shame of psychiatric asylums, but rather toward the ways of leading and governing the global reform process. In this paper four aspects of Jervis critical evaluations are emphasised: a) the criticism toward a "totalitarian" conception considering practices and everyday institutional management as the unique ways to research problem solutions; b) the criticism toward a renewal process exclusively focused inside the psychiatric hospital, which led Jervis to organise one of the most important outside experience in the Reggio Emilia territory; c) the criticism toward a sociological conception of mental illness, disregarding the subjective, psychological and relational aspects of the psychic suffering; d) the criticism toward the inadequacy of the mental health workers formation, which must become the basis of a real transformation of the "public services culture".

Copyright of Psichiatria e Psicoterapia is the property of Giovanni Fioriti Editore and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To present the psychometric properties of the "Consumer-constructed Scale to measure empowerment" (Rogers et al., 1997) Italian version., Methods: After briefly recollecting "history", contents and psychometric features of the original scale, proceeding from Straticò & Degli Esposti's translation (2002), in this paper, the psychometric properties of the Italian version are described. The text of the instrument has been brought for discussion in a users' focus group and subsequently tested for reliability study; a second focus group followed to reach the definitive Italian version., Results: The Italian version of the Scale, consists of 28 items, showed an adequate internal consistency and reliability both for the whole scale and for most of the items, which have shown to have also good discriminative capacity., Conclusions: SESM can be an useful instrument to give empiric evidence supporting empowerment concept. Considering the results, it can be a qualifying and irreplaceable instrument for "empowered condition" evaluation.

Aims: A systematic review of the studies on use of alternative and complementary medicine by mental health services' users to investigate the prevalence and motivations of CAM used to treat mental disorders., Methods: This paper shows a part of the results of a literature review, limited to studies between 1966 and 2005, was carried out using Ovid Medline, PsycINFO and EBM Reviews databases. This was supplemented by hand searching of reference lists., Results: Ninety-one studies on CAM's use by psychiatric patients were analyzed. In this paper the twenty-five articles about the CAM's prevalence and use's motivations are described. The use of complementary and alternative medicine (CAM) varies across countries: data suggest that from 50% to 80% of people suffering of mental disorders use CAM. Heterogeneous methods, samples and results characterizing the studies make generalizations results difficult. Patients motivations of CAM's use were poorly investigated by research, however it seems that persons affected by mental disorders use MAC prevalently because they are dissatisfied with conventional medicine and/or because these alternatives approaches are congruent with their own values, beliefs and philosophical orientation toward health care., Conclusions: The review emphasize the importance of a best physicians' education and information about CAM to improve the management of non-conventional and orthodox medicine relationship. The motivations of CAM's use underline the relevance of patient's holistic conception and the therapeutic role of a patient-physician relationship based on emphaty. Besides it seems important to investigate furtherly patients' psychological and social aspects that influence their choise to use CAM.

Aims: Most of the available evidence on the relationship between socioeconomic indicators of social deprivation and patterns of use of mental health services has been produced in the United Kingdom, where the Ministry of Health has developed a resource allocation formula based upon the results of those studies. The main aim of the paper is to evaluate the replicability in the Italian context of such research, and of the resulting allocation strategies., Methods: Detailed description of the resource allocation method currently adopted in the United Kingdom, whose main purpose consists in reaching the best balance between available funding and patterns of need. Detailed description of resource allocation processes in Italy; discussion of the main methodological and statistical limitations restraining the replicability of the British formula in the Italian context., Conclusions: There is a growing interest in Italy towards the introduction of evidence-based methods in health decision making, in order to correct the overwhelming influence of political issues. What is needed is a better understanding of the relationship between higher levels of equity in health services access, and their effects in terms of better outcomes.

One of the more important aspects of the psychiatric care reform in Italy has been the opening of a great number of psychiatric Non-Hospital Residential Facilities (NHRF). However, 22 years have elapsed since the reform and there are still very scarce data regarding such facilities, the type of patients being accomodated, and the types of treatments provided. The "PROGRES" (PROGetto RESidenze - Residential Project) project is the first national study regarding NHRFs ever carried out in Italy. The objectives of "PROGRES" are to make a survey of all NHRFs in Italy (Phase 1) and to perform a detailed assessment of 20% of the surveyed facilities and of the type of patients being treated (Phase 2). This paper reports the survey (Phase 1) results for the Puglia Region. As of March 31, 2003, 113 psychiatric residential facilities were present in Puglia, with a total of 1.479 beds. This results in an average of 13,08 beds per facility and a rate of 3,86 beds per 10.000 inhabitants. The number of NHRFs present in the territory of each Local Health Unit in Puglia is very variable. Most NHRFs (57%) opened after January 1997. Eighty-three percent have a 24-hour staff coverage while only 5,3% has a 2-hour staff coverage. Eighty five percent of the residential facilities are financed by the Italian National Healthcare System, while a small percentage is privately funded. In over half (69,93%) of the NHRFs the predominant patient age group is 40-59 years; 26,4% of the residential facilities accommodate patients below age 40 and only 3,53% accommodate patients over 60 years old.

Aims: Taking the scientific literature on psychotherapy as a starting point, the paper suggests a few remarks for the debate over psychological treatments in the mental health services in Italy., Methods: A survey of reviews and papers on process and outcome of psychological treatments and on psychotherapeutic practice in mental health services., Results: The paper examines some organizing hypotheses in order to increase psychological treatments supplies., Conclusion: The practicability of such solutions requires on the one hand more attention for empirically supported psychological treatments in mental health professionals training and, on the other hand, that various health services become able to be different in their treatments supply.

Copyright of Cognitivismo Clinico is the property of Giovanni Fioriti Editore and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The present paper represents the second part of a larger review on the studies assessing needs for care in mental health field. In the first part, studies assessing needs for services in the general population were reviewed. In this second part studies assessing needs on individual level were reviewed and the role played by the assessment of individual needs in planning mental health care was discussed., Methods: Studies published in international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs in the general population and in psychiatric patients were reviewed separately. The latter were reviewed on the basis of the diagnostic category (psychotic and non psychotic patients) and setting of care (outpatients and inpatients). Studies on particular categories, such as homeless, children and adolescents, elderly and patients with aggressive behaviour, have been also reviewed., Results: Psychotic patients show a wide range of both clinical and social needs. Patients followed by community-based mental health services show similar number of clinical and social needs, while inpatients (with the exception of acute patients) show more social needs. For both community-based mental health patients and inpatients, social needs are most frequently unmet and psychopharmacological treatments are used more frequently than psychotherapeutic or rehabilitative interventions. Non psychotic patients show lower number of needs than psychotic patients; these needs are both clinical and social, with a higher total number of clinical needs, but a higher number of unmet social needs., Conclusions: Studies on needs for care provide an interesting perspective on people suffering from mental illness. In the routine clinical practice needs assessment could be a valuable tool for providing specific, individualised and effective mental health care.

Objective: Eighteen years after the 1978 reform law no. 180, psychiatric services have to find new roles and goals in the social arena, in order to continue to effectively pursue the improvement of mental health in the community. The aim of the present paper is to show some theoretical and practical elements that could stimulate in the psychiatric services a deep consideration about the relationship between psychiatric services and "private social" bodies, particularly social co-operatives and voluntary organisations., Method: The elements shown in this study come from an analysis: a) of the literature about the crisis factors of the Italian welfare state, particularly in the Public Health Service and in the social assistance; b) of the literature about the development of the "private social" and about the relationship with the public services; c) of national and regional laws, particularly of Veneto region; d) of the present experiences in South Verona Psychiatric Service., Results: The crisis of the traditional welfare state, the emergence in large sectors of general population of needs related to social fragmentation and relational impoverishment, the aspiration of a great number of individuals excluded from society to benefit of the right to full citizenship, all this urgently questions the traditional roles and responsibilities, the organisation, operational modalities, and the community orientation of existing health and human services. Within this framework, the relationship between psychiatric services (or, broadly speaking, public services in general) and "private social" bodies, particularly social co-operatives and voluntary organisations, has become part of a foreseeing, strategic new awareness of mental health workers., Conclusion: A shift from a relationship of mutual exploitation between organisations, to one of co-operation between them, each considering the other as an equal partner, may be a critical step forward a new model of welfare. This, in turn, would hopefully meet the needs for health of the population in terms of efficiency, quality, relevance and consideration of the users' resources and social competencies.

Unlabelled: This paper concerns one of the four research projects developed during a training course in clinical epidemiology managed by the Lombardy training centers IREF., Objectives: To compare the recommendations for treatment concerning 9 vignettes derived from the Australian Quality Assurance Project., Setting: Six Mental Health Services of Regione Lombardia., Design and Participants: For each vignette, all psychiatrists working in the 6 Mental Health Services were asked to fill in a questionnaire about treatment location, psychopharmacology, psychotherapy, priority between psychotherapy and psychopharmacology and degree of difficulty in answering., Results: 44 out of 52 target psychiatrists took part to the study. Remarkable variability for treatment location and psychotherapies; moderate variation for psychodrugs prescriptions and a good agreement for diagnoses were observed. In drugs prescription an access of association was observed. The most prevalent model of psychotherapy was the psychodynamic, followed by the cognitive-behavioural and the family-systemic. There was a tendency toward a flexible approach, as suggested by recommendations of different psychotherapeutic models according to the nature of the disorder. No case were judged very difficult; only in 3 cases a judgement of "somewhat difficult" was expressed by more than 20% (but less than 30%) of the psychiatrists., Conclusions: Studies of this type are very easy to carry out and give useful information for continuous training programs and Continuous Quality Improvement projects.

The role of the nursing staff (which was then not professionally trained) in psychiatric institutes was limited to ensuring that the rules of the institute were respected. After the responsibility for providing assistance had been transferred to Local Psychiatric Services, the role of the professional nurse was radically changed both as a result of the changes in type of patient and the new manner of caring for patients, above all the operational methods used stress the importance of treatment in relations with the patient. The paper analyses the various tasks of the psychiatric nurse which include the initial reception given to the patient, the administration of drugs and evaluation of their effects, the establishment of educational relations with the patient and management of rehabilitation programmes. Whereas the doctor plays a father-role towards the patient due to the authority he possesses, the nurse may be characterised by maternal and caring functions. Given that the lack of theoretical instruments, as possessed by psychiatrists and psychologists, and prolonged contact with patient may expose nursing staff to the risk of damaging their own mental health, it is important to give them specific professional training which will help them handle their relations with psychotic patients.

This paper correlates certain general population variables with that of the users of the Biella Mental Health Service. Age, sex, civic status and schooling are considered. Analysis of the data points to certain risk zones. The significance of these correlations is considered.