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Basaglia Law
Basaglia Law or Law 180 (Italian: Legge Basaglia, Legge 180) is the Italian Mental Health Act of 1978 which signified a large reform of the psychiatric system in Italy, contained directives for the closing down of all psychiatric hospitals and led to their gradual replacement with a whole range of community-based services, including settings for acute in-patient care. The Basaglia Law is the basis of Italian mental health legislation. The principal proponent of Law 180 and its architect was Italian psychiatrist Franco Basaglia. Therefore, Law 180 is known as the “Basaglia Law” from the name of its promoter. The Parliament of Italy approved the Law 180 on 13 May 1978, and thereby initiated the gradual dismantling of psychiatric hospitals. Implementation of the psychiatric reform law was accomplished in 1998 which marked the very end of the state psychiatric hospital system in Italy. The Law has had worldwide impact as other counties took up widely the Italian model. It was Democratic Psychiatry which was essential in the birth of the reform law of 1978.
The law itself lasted until 23 December 1978. Then, its articles were incorporated, with very little changes, into a broader law (Italian: legge 23 dicembre 1978, n. 833 - Istituzione del Servizio sanitario nazionale) that introduced the National Health System.
The general objectives of Law 180/1978 included creating a decentralised community service of treating and rehabilitating mental patients and preventing mental illness and promoting comprehensive treatment, particularly through services outside a hospital network. Law 180/1978 introduced significant change in the provision of psychiatric care. The emphasis has shifted from defense of society towards better meeting of patients' wants through community care. New hospitalizations to the “old style” mental hospitals stopped instantly. The law required re-hospitalizations to cease within two years. Nobody was involuntarily discharged into the community.
The new Italian law was created after conducting the long-term pilot experiments of deinstitutionalization in a number of cities (including Gorizia, Arezzo, Trieste, Perugia, Ferrara) between 1961 and 1978. These pilot experiments succeeded in demonstrating that it was possible to replace outdated custodial care in psychiatric hospitals with alternative community care. The demonstration consisted in showing the effectiveness of the new system of care per its ability to make a gradual and ultimate closure of psychiatric hospitals possible, while the new services, which can appropriately be called “alternative” instead of “complementary” to the psychiatric hospitals, were being created. These services include unstaffed apartments, supervised hostels, group homes, day centers, and cooperatives managed by patients.
In the early sixties, a critical factor for development of the new Law was the availability of widespread reform movements across the country led by the trade unions, the working class, university students, and radical and leftist parties. This unique social milieu led to the passing of innovative legislative bills including legislation on rights for workers, abortion, divorce and finally, Law 180.
Law 180 was based on the following main provisions:
Since the passing of Law 180 in 1978, the Italian Mental Health Act has produced serious debate, disputing its sociopolitical implications, appraising its positive points and criticizing its negative ones. However, the international discussion has never questioned what Law 180 has done to improve the destiny of the mental ill who commit crimes. The Italian experience demonstrates how, when there are no convenient solutions, difficult issues may be sidestepped. Italian legislation has created a dichotomy in mental health treatment: to its credit it has given the law-abiding mentally ill the right to refuse treatment and has stopped all further admission of mental patients; at the same time, it allows the law-breaking mentally ill to be confined in special institutions on indeterminate sentences, thereby depriving them of all civil rights. As a consequence, the approval of Law 180 led to the closure of psychiatric hospitals in Mantova, Castiglione delle Stiviere and in Mombello.
The main long-term consequences of implementation of Law 180 are that:
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Basaglia Law
Basaglia Law or Law 180 (Italian: Legge Basaglia, Legge 180) is the Italian Mental Health Act of 1978 which signified a large reform of the psychiatric system in Italy, contained directives for the closing down of all psychiatric hospitals and led to their gradual replacement with a whole range of community-based services, including settings for acute in-patient care. The Basaglia Law is the basis of Italian mental health legislation. The principal proponent of Law 180 and its architect was Italian psychiatrist Franco Basaglia. Therefore, Law 180 is known as the “Basaglia Law” from the name of its promoter. The Parliament of Italy approved the Law 180 on 13 May 1978, and thereby initiated the gradual dismantling of psychiatric hospitals. Implementation of the psychiatric reform law was accomplished in 1998 which marked the very end of the state psychiatric hospital system in Italy. The Law has had worldwide impact as other counties took up widely the Italian model. It was Democratic Psychiatry which was essential in the birth of the reform law of 1978.
The law itself lasted until 23 December 1978. Then, its articles were incorporated, with very little changes, into a broader law (Italian: legge 23 dicembre 1978, n. 833 - Istituzione del Servizio sanitario nazionale) that introduced the National Health System.
The general objectives of Law 180/1978 included creating a decentralised community service of treating and rehabilitating mental patients and preventing mental illness and promoting comprehensive treatment, particularly through services outside a hospital network. Law 180/1978 introduced significant change in the provision of psychiatric care. The emphasis has shifted from defense of society towards better meeting of patients' wants through community care. New hospitalizations to the “old style” mental hospitals stopped instantly. The law required re-hospitalizations to cease within two years. Nobody was involuntarily discharged into the community.
The new Italian law was created after conducting the long-term pilot experiments of deinstitutionalization in a number of cities (including Gorizia, Arezzo, Trieste, Perugia, Ferrara) between 1961 and 1978. These pilot experiments succeeded in demonstrating that it was possible to replace outdated custodial care in psychiatric hospitals with alternative community care. The demonstration consisted in showing the effectiveness of the new system of care per its ability to make a gradual and ultimate closure of psychiatric hospitals possible, while the new services, which can appropriately be called “alternative” instead of “complementary” to the psychiatric hospitals, were being created. These services include unstaffed apartments, supervised hostels, group homes, day centers, and cooperatives managed by patients.
In the early sixties, a critical factor for development of the new Law was the availability of widespread reform movements across the country led by the trade unions, the working class, university students, and radical and leftist parties. This unique social milieu led to the passing of innovative legislative bills including legislation on rights for workers, abortion, divorce and finally, Law 180.
Law 180 was based on the following main provisions:
Since the passing of Law 180 in 1978, the Italian Mental Health Act has produced serious debate, disputing its sociopolitical implications, appraising its positive points and criticizing its negative ones. However, the international discussion has never questioned what Law 180 has done to improve the destiny of the mental ill who commit crimes. The Italian experience demonstrates how, when there are no convenient solutions, difficult issues may be sidestepped. Italian legislation has created a dichotomy in mental health treatment: to its credit it has given the law-abiding mentally ill the right to refuse treatment and has stopped all further admission of mental patients; at the same time, it allows the law-breaking mentally ill to be confined in special institutions on indeterminate sentences, thereby depriving them of all civil rights. As a consequence, the approval of Law 180 led to the closure of psychiatric hospitals in Mantova, Castiglione delle Stiviere and in Mombello.
The main long-term consequences of implementation of Law 180 are that: