Clash over mental health reform, PD back to 'mental asylums'

There is an open clash between the majority and the opposition on the reform of mental health, after the Senate Social Affairs Committee decided to adopt as the basic text the bill signed by the president of FdI, Francesco Zaffini. According to the PD, the text represents an attempt to tamper with the Basaglia law by taking "serious steps backwards", starting with the reintroduction of what the left calls new "mental asylums".

For their part, the psychiatrists say they want to know the merits of the proposal in its individual points before expressing an opinion, but they specify that they will not deviate from the basic principles of the Basaglia, which see respect for the person and non-segregation as key points. "The center-right majority seems determined to take serious steps backwards also on mental health, by tackling the Basaglia law. The Social Affairs Commission, in fact, has decided to adopt the bill signed by Zaffini as the basic text for the reform, a proposal - this is the alarm raised by the Democratic Party senator Filippo Sensi - that we believe is wrong for three reasons: it introduces what we have defined as 'mental asylums', small residential or semi-residential structures designed for people with mental problems; it increases the maximum duration of TSOs from 7 to 15 days; it codifies the mechanical restraint of people". Sensi refers in particular to excerpts from three articles of the Zaffini bill.

When he talks about "mental facilities" he is referring, among other things, to a part of Article 7: "The regions and autonomous provinces of Trento and Bolzano ensure psychosocial rehabilitation activities through the following structures: rehabilitation centers spread across the territory; residential and semi-residential structures, such as intensive care and rehabilitation facilities, and assisted living facilities; residential or semi-residential structures of a socio-assistance nature". On the duration of compulsory health treatments, the reference is to Article 5: the TSO "has a maximum duration of fifteen days, extendable only in the case of actual clinical needs". As for mechanical restraint, the Democrat focuses on Article 4 of the bill: "Mental health workers implement physical, pharmacological and environmental coercive measures and treatments only in cases connected to documented clinical needs and for the sole purpose of preventing self- and other-harmful behavior, respecting the dignity and safety of the person affected by mental disorders". "It would be very serious if the right wanted to tamper with the Basaglia law - also comments Luana Zanella, AVS group leader in the Chamber - The Zaffini bill effectively restores mental hospitals, private ones at that. It is scary that every move by the right is aimed at undermining the greatest democratic reforms, re-establishing ghettos for those on the margins". For her part, the outgoing president of the Italian Society of Psychiatry (SIP), Emi Bondi, stresses that she wants to wait to know the proposal well, and any amendments, before giving an assessment: "We want to better evaluate the text in its individual points - she states to ANSA -. It is clear that an update of the Basaglia law, after 40 years, is necessary because situations and social reality have changed, but this law remains fundamental and its spirit and basic principles must be preserved". And again: "We are available to discuss the individual points. We do not want to enter into political dynamics of defense or attack of a proposal but we want to evaluate it carefully". In fact, "no psychiatrist wants to go back to mental hospitals, which are out of time and out of current logic, but at the same time - Bondi points out - this does not mean that patients cannot be admitted or have assistance when even the family is no longer able to manage them. There is a great demand for residential care. It is a matter of getting to the heart of a complex issue without an ideological stance but thinking concretely about the needs of the sick and safeguarding the principles of the Basaglia law, starting with respect for the sick person and no to segregation". Therefore, Bondi concludes, "we are waiting to know the contents better, but we are not derogating from the basic principles of the Basaglia, which must be protected".