Oltre la 180.

There is a full-blown crisis of the mental health system recognized by all but explained in a non-unanimous way. Two approaches are described, “denotative” and “connotative”, on the basis of which two theses called, respectively, “unfinished symphony” and “beyond the Law 180”, are developed. The first refers to an incomplete reform process that has generated aporias, contradictions, fallacies and paradoxes with which many psychiatrists identify several factors such as the folowing: changes in the need for care, “manufacturig defects” of Law no. 180/1978, problems of psychiatric services, difficult relationship between public psychatric services and the private sector, increasing admissions and days of hospitalizations in residential facilities, lack of fight against mental health stigma, stress of mental health professionals and their insufficient training, limited resources. The “depot effect” of these factors, releasing and amplifying other criticalities, leads to a lower credibility linked to a diminished “perceived value” of the mental health system, and testifies to an epistemic crisis linked to a change of the original ideology that could not be transformed into science due to the halting of a reform process that should go beyond Law no. 180 of 1978. If ideology in mental health becomes science, the challenge of the psychiatry reform will be won and the mental health crisis will be resolved. [ABSTRACT FROM AUTHOR]