Below is a press release issued by ASL Bari:
From the closure of the old Judicial Psychiatric Hospitals (OPG) to the complicated launch of the Residences for the Execution of Security Measures (REMS). A small “revolution”, still underway, for the structures and operators involved in the custody and care of offenders suffering from psychiatric pathologies. A long journey but also full of perspectives around which the ASL Bari yesterday organized the event “Dangerous relationships – Psychiatry between care and custody”, an entire day dedicated to the training of 200 healthcare workers and, at the same time, to initiate a profound reflection between magistrates and psychiatrists with the aim of building together shared paths capable of improving the common vision between legal provisions and concrete implementation, especially at the level of territorial psychiatric structures. Also in light of a phenomenon which, in the ASL Bari alone, consists (in 2023) of 267 offenders with psychiatric pathologies (mainly personality disorders, alcohol and substance abuse) belonging to Mental Health Centres, of which 56 percent placed in the Psychiatric Assistance Rehabilitation Community (CRAP) and the rest managed within structured pathways, including waiting for inclusion in the two REMS structures active in Puglia: in Spinazzola (BT) and in Carovigno (BR).
Multi-voiced dialogue, strongly desired by Luigi Fruscio, Acting General Director of the ASL Bari, in which mental health professionals took part such as Anna Maria Camposeo, Director of the Area 7 Mental Health Centre, Roberto Catanesi, Full Professor of Forensic Psychopathology (University of Studies of Bari) and Guido Di Sciascio, Director of DSM ASL Bari, and representatives of Justice, such as Silvia Maria Dominioni, President of the Surveillance Court of Bari, Eugenia Pontassuglia, Public Prosecutor at the Court of Taranto and Angela Tomasicchio, Attorney General of Court of Appeal of Bari. Particularly interesting is the point of view of Nicola Graziano, magistrate and author of the investigative book “Matricola zero zero uno”, a real “journey” into madness and suffering (with photos by Nicola Baldieri) – experienced first hand – through the hard and raw stories of the inmates of the Judicial Psychiatric Hospital of Aversa; events also became a theatrical piece, staged in Putignano by the Associazione theater company “Il Colibrì” as part of the National Theater-School Review “PulciNellaMente”.
The starting point of the broad reflection on psychiatric pathology and crimes was the legislative passage marked by law 81 of 2014, whose laborious application brought to light important issues, both management and in reference to the principles of treatment themselves. Hence the hope, which emerged during the day, for a revision of Law 81 which brings the prerogatives relating to care back into the right places, distinct from those relating to safety.
Law 81/2014, moreover, sanctioned the closure of the Judicial Psychiatric Hospitals (OPG) and the establishment of the Residences for the Execution of Security Measures (REMS), a turning point intimately linked to the dismantling of the mental hospital in every its form and the definitive overcoming of the custodial culture, initiated at the time with the Basaglia law (180/1978). However, the initial needs assessment was found to be insufficient compared to the incremental demand for places. This is the scenario with which psychiatric rehabilitation facilities and hospital Psychiatric Diagnosis and Treatment Services (SPDC) are called upon to overcome the existing critical issues with an enormous effort by healthcare workers and magistrates.
At the basis of this, as has been underlined, there is the total delegation to the National Health System of the management of patient offenders, the overlap between the obligation to protect and protect the community and requests for care for the sick person. With the effect of placing the centrality of the patient and his needs and having repercussions on common feeling, risking re-proposing in public opinion the dangerous relationship between crime and madness, deviance and illness, fueling prejudices and new pressures towards the exclusion of patients psychiatric disorders and distrust and suspicion towards operators. Precisely that stigma that has been laboriously fought in the name of the rights of people suffering from mental disorders and for the promotion of the mental health of the population, cornerstones that the ASL Bari event aimed to re-propose and strengthen.
