Approaches to Treating Mental Illness: An iQuest Study of Italy

I traveled to Italy. Ms. Bodnar and I landed in Rome and met with the Head of the Department of Mental Health at the National Institute for Scientific Research, Dr. Gadinni. We toured a historic asylum which has been converted into a museum about the mental health reform. From Rome, we traveled to Trieste, a small town on the border of Italy and Slovenia. While there, we met with the State Head of the Department of Mental Health, Ms. Battiston. We toured the current facilities provided by the state, as well as several farms, factories, stores, and radio stations that partnered with the state mental health program to employ people with disabilities, ranging from bipolar disorder to a patient who received the last lobotomy in Italy in 1979. We met with patients and heard about their positive experiences with this program.

While in Trieste, I learned that in 1968, a man named Franco Basaglia became the Head of the San Giovanni Mental Asylum. He saw how inhumanely patients were being treated, and decided that a reform needed to take place. In 1978, a law was passed to shut down all mental asylums in the country and begin the practice of community psychiatry. It took almost 30 years, but the reform has ended and now all asylums have been closed. Each province runs their program differently, but they are all based on the same approach and the same laws for humane treatment apply to all.

I started my iQuest by asking which country has the best mental health program, why, and how the US can learn from it. The countries with the best mental health care programs are Germany, Australia, and the U.K. However, the Italian program is the most advanced in the developed world, and both the German and Australian programs are based on the Italian Program’s heavy emphasis on human rights. Even the city of San Francisco has started to implement parts of the Trieste Model. Now, in Italy's current economic state, their program is at risk. Their program is based on a community approach called community psychiatry. It involves moving patients into the city and integrating them into the community, as opposed to locking them away on the outskirts of the city. They partner with businesses across the city to ensure a feeling of inclusion amongst all patients. This also decreases the stigma around mental illness, and crime rates saw a decrease when help became accessible, affordable, and socially acceptable.

In college, I plan on studying human rights, specifically for those suffering from mental illness. Currently, there are few laws in the US that protect people with mental illness. Finding help is very difficult, and people who need help are often ostracized. In many treatment facilities in the US, abuse of power is very common, since there are few things in the way of stopping it. It is examples like this, and how close I am to people who have experienced it, that I want to change the way the mental health system in the US functions. I want to raise awareness in hopes of decreasing the stigma around mental health. I plan on using what I've learned in college and beyond when it comes time to change our system on a state and national level.

I will never forget how happy some of the patients seemed. They greeted us with open arms and were so happy to hear that other people wanted to change programs to look more like theirs. They invited us into their houses, cooked for us, and were so happy to speak to us. Some people, it was quite obvious, were patients, but others it was difficult to tell that there was anything different about them. Seeing that there was almost no stigma around the issue in this city further inspired me to work hard and make sure that people in the US and all over the world can feel the same way.