Research Reports & Articles

For research purposes, reports and articles have been curated to offer information about the system, its history and its operation in the Dipartimento di Salute Mentale Trieste (DSM Trieste) and in other locations within and outside of Italy.  Translated articles are provided courtesy of Google Translate, and do not provide exact translations of the original document. This list will be continually updated as new resources are gathered.  

  • ”The punishment and the cure. Mental health services in Italy after the closure of judicial psychiatric hospitals” by Roberto Mezzina, 2017, translated from La pena e la cura. I servizi di salute mentale in Italia dopo la chiusura degli ospedali psichiatrici giudiziari

    • A discussion on the implementation of community-based measures to addressing the rehabilitation of mentally ill offenders involved with the judicial system in Italy, the uneven  application of national law, and the use of the system of Residences for the Execution of Security Measures (Residenze per l’esecuzione delle misure di sicurezza – REMS) as an alternative to the “Judicial Psychiatric Hospitals” (Ospedali Psichiatrici Giudiziari – OPG).

  • ”Innovation in Socio-Health Integration: Descriptive Study of the Skills of the Microarea Referent” by Cristina Brandolin and Claudia Miniussi, 2017 (graduate thesis regarding the Micro-area system in Trieste), translated from L’innovazione nell’integrazione sociosanitaria: studio descrittivo delle competenze del referente di Microarea

    • Abstract: Health is a complex process in which multiple factors, known as determinants, come into play. In the area of social and health services, the main task is to intervene at different levels to protect the health and wellbeing of people according to a holistic concept as opposed to a fragmented vision. The problem of social and health services integration, besides having to consider the variety and complexity of organizations operating on the social and health services scene, strongly refers to the multidimensional nature of many health problems and, above all, to an integrated conception of people's health and well-being.

  • ”Creating mental health services without exclusion or restraint but with open doors in Trieste Italy” by Dr. Roberto Mezzina, 2016

    • Abstract: The city of Trieste is an internationally known experience that started in 1971 under the direction of the great figure of Franco Basaglia, and resulted in the first closure of a psychiatric hospital in Europe more than 35 years ago. The Mental Health Department has been recognised as a WHO collaborating centre for many years and it is considered as a sustainable model for service development without any psychiatric hospital support. Trieste has shown a different approach for innovative community mental health that has moved from a narrow clinical model based on the illness and its treatment to a broader concept that involves the whole person at the centre of the care system, with the highest attainable level of freedom and respecting their power of negotiation. The emphasis is on recovery as well as human and citizenship rights, in order to respond according to needs, to integrate care in people’s lives and aspirations and foster participation to service development. The organization is based on 24 hour CMH centres with a few community beds in each centre, a very small GH unit, a high number of social cooperatives, supported housing schemes and other innovative programmes in the area of recovery and social inclusion. Results show a demonstration of cost-effectiveness as well as the capacity to contrast stigmatisation, discrimination and exclusion of people suffering from mental health issues.

  • “A Tale of Two Cities: The Exploration of the Trieste Public Psychiatry Model in San Francisco” by Elena Portacolone, Roberto Mezzina, Nancy Scheper-Hughes, and Robert L. Okin, 2015

    • 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.

  • ”Franco Basaglia and the Transformation of Psychiatry” by Mario Colucci and Pierangelo Di Vittorio, 2007

    • In our view, Franco Basaglia’s conferences in Brazil in June and November, 1979 (published in Italian as Conferenze Brasiliane, 2000) provide the best introduction to his work. The passion of his discourse, the forceful denunciation of the miserable state of psychiatry and the intensity of the practical experiences of change taking place at that time, all contribute to making Conferenze Brasiliane an exceptional document. But what is perhaps most remarkable about these conferences is Basaglia’s style, a style by which the Italian psychiatrist seems to say: “I have nothing to teach.”

  • ”Deinstitutionalisation in Italy: between ethics and politics” by M. Colucci, B. Norcio and C. Sinidici, 2001

    • The purpose of this paper is to illustrate how the process of deinstitutionalization, which began in Italy in the early sixties and culminated with the psychiatric reform law of 1978, was the result of a long history of anti-institutional practices which have led not only to the closing down of the psychiatric hospitals but also to a radical reevaluation of the ethical and cultural underpinnings of Italian psychiatry. It should be noted that this process took place with great difficulty, very unevenly and with serious delays and, in fact, has yet to be fully terminated. However, the reform is a one-way street and any thought of returning to the past of the asylum is now both unthinkable and impracticable.