Application of the Psychiatric Reform Act in the city of Naples. A survey of requests for compulsory admission to the special unit at the University Psychiatric Department I.
One of the most patent inconsistencies in the application of the 1978 Psychiatric Reform Act in many areas of Southern Italy has resulted from the irrational choice, by regional governments, of the general hospitals in which Psychiatric Special Units had to be implemented, and from the inappropriate determination of territorial boundaries defining the competence of such Units. Thus, in the city of Naples, it was decided, in June 1978, to set up Psychiatric Special Units only in the two University Psychiatric Departments and in the Psychiatric Emergency Ward at S. Gennaro Hospital. These Units, equipped with an overall number of 39 beds, were put in charge with the whole province of Naples (about three millions inhabitants). Quite arbitrarily, it was established that University Departments had to admit patients coming from the city of Naples and S. Gennaro Hospital those residing in the rest of the province. By an equally arbitrary choice, female patients from the city of Naples were entrusted to the University Department I and male patients to the Psychiatric Department II. In the following years, from 1979 to 1983, some additional Units were set up in general hospitals of the Naples province. Nonetheless, available beds have not exceeded the overall number of 69, and the catchment areas of the three pre-existing Special Units have not been modified. The chaotic situation engendered by this incongruous application of the Reform Act is outlined, by means of an analysis of the requests for compulsory admission addressed to the Special Unit at the Psychiatric Department I of Naples University during the periods June 16, 1978-December 31, 1979 and June 16, 1982-December 31, 1983.
D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence* / Q000639:trends; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence* / Q000639:trends; D005260:Female; D006801:Humans; D007558:Italy; D001523:Mental Disorders / Q000628:therapy*; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000639:trends