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In Italy an ongoing process of deinstitutionalization unprecedented in the world is been enacted. The Judicial Psychiatric Hospitals, that were never reformed in the past 80 years, are now on the edge of their closure. This process is being implemented through a layering of rules that had no purpose other than the rapid closure of these structures. The Mental Health Departments have now the responsibility of a multiplicity of new and highly specialized tasks, and an extension of their power to control. There is no previous organization for these tasks in the Mental Health System. Some of the recently enacted laws, such as the Law 81 of 2014, are intented to solve some problems, althought issues of deinstitutionalization are getting worse. In our opinion several management aspects of this population of severe psychiatric patients are unfit with the present organization of the Mental Health Services. There is need for legislative action coordinated and based on a long-term perspective.

Introduction: The most important predictive factor for a successful outcome in Brief Psychotherapy is the motivation of patients to the treatment itself. Against the scarcity of literature on the subject, so far limited to offer standardized tools to assess motivation, applied mainly to education and work's areas, in spite of a possible application in psychotherapy, it was considered necessary to develop a questionnaire ad hoc., Materials and Methods: It was therefore created a pattern of motivational diagnosis of the problem based on a sequence of questions and answers, which would make possible the classification of each case and then that could lead to the use of a specific method. It is the result of the attempt to create an orderly pattern and that it would be easy to use and then be analyzed. The questionnaire consists of twenty one questions and requires that the patient answers with a "yes" or a "no" to each applicant. It was administered to thirty patients who came from the psychiatric day hospital. The questionnaire was used as a "not standardized thread" in which, through groups of questions, are addressed some central cores: the spontaneous activity, motivation controlled from the outside, motivation directed to an activity that leads to results, motivation to and activity for a purpose, expectations of self-efficacy, the presence/absence of resistance and finally the area of the will. The purpose of this work is to show, bringing a contribution in agreement with the few studies on the subject, how motivation is a key parameter for predicting the effectiveness of a psychotherapy, in this case, Brief Psychotherapy., Conclusions: The study clearly shows how the motivation is the most important positive predictor in the preliminary assessment of a Brief Psychotherapy: results in treatment are most likely to be rapid and favorable if patients are motivated to change andif they are engaged with the therapist.

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.

Objective: Following the introduction of guidelines of rational drug use, the pharmacoepidemiology of psychotropic drugs was investigated in a sample of long-stay patients living in a Italian psychiatric hospital., Design: A prospective, longitudinal two-year follow-up study was carried out. Information about sociodemographic and clinical characteristics of the inpatient population, and about medications prescribed, was collected at baseline and after one and two years of follow-up., Setting: Three wards of the psychiatric hospital of Milan., Main Outcome Measures: Number of patients taking psychotropic drugs, number of patients taking more than one neuroleptic or benzodiazepine, mean neuroleptic dose, psychopathological status according to the Brief Psychiatric Rating Scale (BPRS)., Results: 70 patients were recruited and followed for two years. At follow-up a reduction in the number of patients taking neuroleptic drugs was recorded, together with a 50% decrease in the number of patients taking more than one neuroleptic. A reduction in the use of depot formulations was in addition shown. Patients taking benzodiazepines decreased of 50%. According to the BPRS, no psychopatological changes were observed during the study., Conclusions: These data suggest that education in psychopharmacology may guide towards a more rational use of drugs; longitudinal clinical audits should be implemented to monitor everyday practice.

The present research studies the evaluation in the Judicial Psychiatric Hospital of Castiglione delle Stiviere, as the treatment of the criminal mental illness (Psychopathology) has been evolving after the normative change that has abolished every form of legal presumption of social danger. Eighty-three files were analysed during the period January 1991 to March 1993 relative to the interns of the J.P. Hospital; particularly examined were the evaluation methods high-lighted by the observation group and the treatment called into use to supply an opinion on the dismissal of the (same) interns and on the consequences (or not) of admitting them into a form of outpatient treatment.

The psycho-social problems of a group of 365 Italian emigrants to Switzerland, admitted to psychiatric hospitals, were studied. It was found that non professional subjects (housewives, unemployed, retired) and manual workers (builders, waiters, factory workers) were more likely to suffer from psycho-social disorders. Only 11.1% of those studied had received a secondary education, therefore it could be assumed that subjects having a low technical and cultural level were less prepared, psychologically, for their new situation and were thus more susceptible to psycho-social disorders. The most frequent diagnoses were found to be: affective disorders, alcohol addiction, opiate addiction and schizophrenia. The study revealed that emigrants ran a greater risk of first time admittance to psychiatric wards whereas the local population had a greater number of relapses. In conclusion it is stressed that assistance with an aim to improve work, social and relationship conditions and to integrate the emigrants into their host society can reduce some forms of psycho-social disorders.

The paper reports the findings of a 10-year statistical survey of the users and activities of the Mental Health Service Of S. Giovanni in Fiore (Cosenza). The incidence of booth voluntary and TSO hospitalisation is reported in relation to users and with reference to the Centre's activity during other periods.

The Authors describe the organization and aims of the rehabilitation institute "G. Ferrero" of Alba, Cuneo district, Italy. Afterwards they present, analyse and compare 34 items regarding patients over 14 years of age that were present on the 30 November 1978 and 1988. The most important data are: 1) a large rise in average age and stay at the institute; 2) a similar rise in the mental retardation level; 3) the lack of link between handicap level and possibility for the subject to go back to the original family; 4) a considerable increase in the subjects with psychosis or cerebropathia; 5) the poor prognosis for psychotic subjects, that are affected 10 years after and almost never succeed in going back to their original family or in finding a job; 6) big changes that changing types of patients produced in the institute's aims and in treatment, with partial renunciation to rehabilitation and development of nursing and ergotherapy.