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Heterogeneity of the Departments of Mental Health in the Veneto Region ten years after the National Plan 1994-96 for Mental Health. Which implication for clinical practice? Findings from the PICOS Project

Published online by Cambridge University Press:  18 May 2011

Antonio Lasalvia ,
Bruno Gentile ,
Mirella Ruggeri ,
Alessandro Marcolin ,
Flavio Nosè ,
Lodovico Cappellari ,
Dario Lamonaca ,
Emanuele Toniolo ,
Claudio Busana  and
Antonio Campedelli
...Show all authors
Michele Tansella
Affiliation:
GRUPPO PICOS-VENETO
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Summary

Aims - This study aims to present data on structural and human resources of public mental health services located in the Veneto Region, Italy, and to discuss them in the light of implementation of the first National Target Plan for Mental Health (“Progetto Obiettivo 1994-1996”) ten years after its launch. Methods - The study was conducted in the context of the PICOS (Psychosis Incident Cohort Outcome Study) Project, a large first-presentation multisite study on patients with psychotic disorders attending community mental heath services in the Veneto Region. Human and structural resources were surveyed in 26 study sites using a structured interview administered by the PICOS local referents. Results - CMHCs and Day Centres were homogeneously distributed across the Region and their overall rates per resident population met the national standards; a wide variability in the distribution of Day Hospitals was found, with the overall rate per resident population very far from meeting the national standard; the overall rate for Residential Facilities beds was higher than the recommended national standard, showing however an high variability across sites. The overall rate of mental health professionals per resident population was only slightly below the national standard: this was mainly achieved thanks to non-profit organizations which supplement the public system with unspecialised professionals; however, a wide variability in the local rates per resident population was found, with the 50% of the sites showing rates far lower the national standard. Specific lack of trained professionals involved in the provision of psychosocial interventions was found in most sites. Conclusions - A marked variability in human and structural resources across community mental health services in the Veneto Region was found. Possible reasons for this heterogeneity were analysed and implications for mental health care provision were further discussed.

Declaration of Interest: The study has been supported by the Regione del Veneto, Giunta Regionale, Ricerca Sanitaria Finalizzata 2004, Venezia, Italia (grant to Professor M. Ruggeri).

Keywords

community caremental health servicespsychiatric facilitiesmental health professionalsItaly.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 16 , Issue 1 , March 2007 , pp. 59 - 70
Copyright
Copyright © Cambridge University Press 2007

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References

Alden, L. 1978. Treatment environment and patient improvement. Journal of Nervous and Mental Disease 166, 327–334.CrossRefGoogle ScholarPubMed
Amaddeo, F., Bacigalupi, M., de Girolamo, G., Di Munzio, W., Lora, A. & Semisa, D. 1998. Attività, Interventi e Strutture del Dipartimento di Salute Mentale. Epidemiologia e Psichiatria Sociale, Supplemento Monografico n.2. II Pensiero Scientifico Editore: Roma.Google Scholar
Becker, T. 1985. Psychiatric reform in Italy: how does it work in Piedmont? British Journal of Psychiatry 147, 254–260.Google ScholarPubMed
Bollini, P., Reich, M. & Muscettola, G. 1988. Revision of the Italian psychiatric reform: North/south differences and future strategies. Social Science and Medicine 27, 1327–1335.CrossRefGoogle ScholarPubMed
Burti, L. 2001. Italian psychiatric reform 20 plus years after. Acta Psychiatrica Scandinavica 104, Suppl. 410, 41–46.CrossRefGoogle Scholar
Christenfeld, R., Wagner, J., Pastva, G. & Acrish, W.P. 1989. How physical settings affect chronic mental patients. Psychiatric Quarterly 60, 253–264.CrossRefGoogle ScholarPubMed
Cozza, M. & Napolitano, G.M. (a cura di) 1996. L'Assistenza Psichiatrica in Italia: la Normativa e la Diffusione dei Servizi sul Territorio. Secondo Rapporto. Istituto Italiano di Medicina Sociale: Roma.Google Scholar
Crepet, P. 1990. A transition period in psychiatric care in Italy ten years after the reform. British Journal of Psychiatry 156, 27–36.CrossRefGoogle ScholarPubMed
Decreto Presidente della Repubblica 1994. Approvazione del Progetto Obiettivo “Tutela della Salute Mentale, 1994-1996”: DPR 07.04.94. Gazzetta Ufficiale della Repubblica ItalianaGoogle Scholar
de Girolamo, G. & Cozza, M. 2000. The Italian psychiatric reform. A 20-year perspective. International Journal of Law and Psychiatry 23, 197–214.CrossRefGoogle ScholarPubMed
de Girolamo, G. & Tansella, M. 2006. I reparti psichiatrici in ospedale generale. Problemi e prospettive in Europa. Epidemiologia e Psichiatria Sociale 15, 85–90.CrossRefGoogle Scholar
DGR Veneto 2000. DGR Veneto n.4080 del 22.12.2000. Progetto Obiettivo per la tutela della salute mentale. Aggiornamento (LR n. 5/1996, commi 1 e 2).Google Scholar
De Salvia, D. & Barbato, A. 1993. Recent trends in mental health services in Italy: an analysis of national and local data. Canadian Journal of Psychiatry 38, 185–186CrossRefGoogle ScholarPubMed
Eklund, M. & Hansson, L. 1997. Relationships between characteristics of the ward atmosphere and treatment outcome in a psychiatric daycare unit based on occupational therapy. Acta Psychiatrica Scandinavica 95, 329–335.Google Scholar
Ferrannini, L. 2002. II Dipartimento di Salute Mentale è un servizio di psichiatria di comunità? Psichiatria di Comunità 1, 77–85.Google Scholar
Fioritti, A., Lo Russo, L. & Melega, V. 1997. Reform said or done? The case of Emilia-Romagna within the Italian psychiatric context. American Journal of Psychiatry 154, 94–98.Google ScholarPubMed
Gruppo Nazionale PROGRES 2001. Le strutture residenziali psichiatriche in Italia. I risultati della fase 1 del progetto PROGRES. Epidemiologia e Psichiatria Sociale 10, 260–275.Google Scholar
Lasalvia, A., Ruggeri, M., Bertani, M., Bonetto, C., Bissoli, S., Marrella, G., Cristofalo, D. & Tansella, M. on behalf of the PICOS-VENETO Group (in preparazione). Caring for emotional well-being of mental health professionals to improve treatment outcomes: a survey on job burnout in community mental health services of the Veneto Region, Italy. Results from the Psychosis Incident Cohort Outcome Study (PICOS).Google Scholar
Lehman, A.F., Kreyenbuhl, J., Buchanan, R.W., Dickerson, F.B., Dixon, L.B., Goldberg, R., Green-Paden, L.D., Tenhula, W.N., Boerescu, D., Tek, C., Sandson, N. & Steinwachs, D.M. 2004. The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003. Schizophrenia Bulletin 30, 193–217.CrossRefGoogle ScholarPubMed
Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., Favata, G., Sasso, A., Prezioso, M., Pezzenati, L., Gentile, F., Casale, L., Bondi, E., Test, G.R., Di Leila, M, Biscussi, E., Degl'Innocenti, F., Bellini, R., Di Nunzio, R., Matrella, L., Salmeri, R., Cantone, R., Gargiulo, L., Esposito, A., Delcuratolo, V., Giannini, M., Maresca, L., Cavaliere, G., Scandone, B., Folia, M., Raffaeli, M., Innocente, P., Dagianti, F., Lucania, S., Scorsino, A., Bardicchia, F., Cerullo, G., Curreli, R., Miscali, S., Scordato, M., Campo, G., Mameli, C., Sodde, C., D'Ambra, L., Malacarne, A. & Maj, M. 2005. Aspetti positivi e difficoltà nella; diffusione degli interventi psicoeducativi familiari nella pratica clinica: uno studio muticentrico in 23 CSM italiani. Epidemiologia e Psichiatria Sociale 14, 235–242.CrossRefGoogle Scholar
Maj, M., Starace, F. & Kemali, D. 1989. Implementing psychiatric reform in southern Italy: the case of Campania. International Journal of Social Psychiatry 35, 46–53.CrossRefGoogle ScholarPubMed
Ministero della Salute 2001. Rilevazione 2001 del Personate e Strutture dei Dipartimenti di Salute Mentale, a cura della Direzione Generale della Prevenzione - Ufficio X: Roma.Google Scholar
Ministero della Salute (2004). Annuario Statistico del Servizio Sanitario Nazionale 2003. Roma.Google Scholar
Ministero della Sanità 1998. Stato di Attuazione del Processo di Superamento degli Ospedali Psichiatrici e di Realizzazione dei Dipartimenti di Salute Mentale (Legge N. 449/1997), a cura dei Dipartimenti della Prevenzione e della Programmazione (Vol. I e II). Roma.Google Scholar
Morandin, I. & Favaretto, G. 2005. Espansione del privato sociale all'interno dei Dipartimenti di Salute Mentale tra rischi e vantaggi. Psichiatria di Comunità 4, 230–237.Google Scholar
Nash, L., Gorrell, J., Cornish, A., Rosen, A., Miller, V. & Tennant, C. 2004. Clinical outcome of an early psychosis intervention program: evaluation in a real-world context. Australian and New Zealand Journal of Psychiatry 38, 694–701.CrossRefGoogle Scholar
NICE 2003. Schizophrenia. Full National Clinical Guideline on Core Interventions in Primary and Secondary Care. Gaskell: London “ed. Carrà, Italiana a cura di G., Barale, F. & Marinoni, A. 2004. Schizofrenia. Linee Guida Cliniche Complete per gli Interventi Fondamentali nella Medicina di Base e Specialistica. II Pensiero Scientifico Editore: Roma”.Google Scholar
Perris, C. & Kemali, D. 1985. Focus on the Italian psychiatric reform: an introduction. Acta Psychiatrica Scandinavica, Supplementum No. 316, 9–25.CrossRefGoogle ScholarPubMed
Piccinelli, M., Politi, P. & Barale, F. 2002. Focus on psychiatry in Italy. British Journal of Psychiatry 181, 538–544.CrossRefGoogle ScholarPubMed
Regione Veneto 2000. Assistenza Psichiatrica. In Relazione Socio- Sanitaria della Regione Veneto 2000, pp. 121–132. Giunta Regionale del Veneto: Venezia.Google Scholar
Regione Veneto 2002. Assistenza Psichiatrica. In Relazione Socio- Sanitaria della Regione Veneto 2002, pp. 173–182. Giunta Regionale del Veneto: Venezia.Google Scholar
Regione Veneto 2004. Assistenza Distrettuale e Servizi Sociali. Salute Mentale. In Relazione Socio-Sanitaria della Regione Veneto. Anno 2004, pp. 233–242. Giunta Regionale del Veneto: Venezia.Google Scholar
Rossberg, J.I., Melle, I., Opjordsmoen, S. & Friis, S. 2006. Patient satisfaction and treatment environment: a 20-year follow-up study from an acute psychiatric ward. Nordic Journal of Psychiatry 60, 176–180.CrossRefGoogle ScholarPubMed
Royal Australian and New Zealand College of Psychiatrists 2005. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders. Australian and New Zealand Journal of Psychiatry 39, 1–30.CrossRefGoogle Scholar
Ruggeri, M., Leese, M., Thornicroft, G., Bisoffi, G. & Tansella, M. 2000. Definition and prevalence of severe and persistent mental illness. British Journal of Psychiatry 177, 149–155.CrossRefGoogle ScholarPubMed
Santone, G.de Girolamo, G., Fallon, I., Fioritti, A., Micciolo, R., Picardi, A., Zanalda, E. & Svettini, A. 2004. II Processo assistenziale nelle RS. In Le Strutture Residenziali e i Loro Ospiti: i Risultati della Fase 2 del Progetto Nazionale PROGRES (Girolamo, G. de, Picardi, A., Santone, G., Semisa, D., Morosini, P. & Gruppo Nazionale PROGRES), pp. 22–44. Epidemiologia e Psichiatria Sociale, Monograph Supplement 7, II Pensiero Scientifico Editore: Roma.Google Scholar
Tansella, M, Williams, P 1987. The Italian experience and its implications. Psychological Medicine 17, 283–289.CrossRefGoogle ScholarPubMed