title: A Tale of Two Cities: The Exploration of the Trieste Public Psychiatry Model in San Francisco.
abstract: According to the World Health Organization (WHO), the "Trieste model" of public psychiatry is one of the most progressive in the world. It was in Trieste, Italy, in the 1970s that the radical psychiatrist, Franco Basaglia, implemented his vision of anti-institutional, democratic psychiatry. The Trieste model put the suffering person-not his or her disorders-at the center of the health care system. The model, revolutionary in its time, began with the "negation" and "destruction" of the traditional mental asylum ('manicomio'). A novel community mental health system replaced the mental institution. To achieve this, the Trieste model promoted the social inclusion and full citizenship of users of mental health services. Trieste has been a collaborating center of the WHO for four decades with a goal of disseminating its practices across the world. This paper illustrates a recent attempt to determine whether the Trieste model could be translated to the city of San Francisco, California. This process revealed a number of obstacles to such a translation. Our hope is that a review of Basaglia's ideas, along with a discussion of the obstacles to their implementation, will facilitate efforts to foster the social integration of persons with mental disorders across the world.
authors.affiliation: Institute for Health and Aging, University of California, San Francisco, USA. Elena.portacolone@ucsf.edu.|Institute for the Study of Societal Issues, University of California, Berkeley, USA. Elena.portacolone@ucsf.edu.|Mack Center on Mental Health and Social Conflict, University of California, Berkeley, USA. Elena.portacolone@ucsf.edu.
authors.forename: Elena
authors.initials: E
authors.lastname: Portacolone
authors.affiliation: Mack Center on Mental Health and Social Conflict, University of California, Berkeley, USA.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Segal
authors.affiliation: Trieste Department of Mental Health, Trieste, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mezzina
authors.affiliation: Anthropology Department, University of California, Berkeley, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Scheper-Hughes
authors.affiliation: Department of Psychiatry, University of California, San Francisco, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Okin
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D007558:Italy; D001523:Mental Disorders; D008960:Models, Psychological; D011570:Psychiatry; D012495:San Francisco; D014944:World Health Organization
keywords: Anthropology; Basaglia; Mental Health; World Health Organization