[How do we treat the broad spectrum of patients with serious mental illness who have committed crimes? The Law 81/2014: limits and problems].

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.