The protracted process of reform of forensic psychiatric institutions in Italy

The Italian system of forensic psychiatric institutions - for offenders with mental disorders adjudicated as not guilty by reason of insanity - is described in the Criminal Code. This system has been greatly modified by ensuing constitutional rulings and legislative actions that modelled the forensic organization in response to the contemporary approach in psychiatric care. However, the forensic psychiatric institutions have maintained their past prison’s organization, i.e. geographical location and personnel composed essentially by prison guards. Threat to society triggers the application of social safety measures and induces the utilisation of forensic psychiatric institutions. The concept of social dangerousness - absolute in the Criminal Code - has become more flexible over time. Each individual and it’s family resources should be assessed case by case. The Decree of the President of the Council of Ministers (DPCM 1/4/2008) declared in 2008 that forensic psychiatric institutions were now part of the NHS and that the treatment of forensic patients should be taken on by the region of origin of each patient. Annex C of this decree describes the organisational steps towards regional health care of forensic patients. Forensic psychiatry becomes as a result part of general psychiatry, abandoning the old model of forensic psychiatric institutions.

Keywords: Social threat, closure of forensic psychiatric hospital, territorialisation

• The closing of forensic psychiatric hospitals in Italy: Determinants, current status and future perspectives. A scoping review Claudio Di Lorito, Luca Castelletti, Ilaria Lega, Barbara Gualco, Franco Scarpa, Birgit Vӧllm, in International Journal of Law and Psychiatry /2017 pp.54
  DOI: 10.1016/j.ijlp.2017.10.004

Alessandro Margara, Il lungo processo di superamento degli ospedali psichiatrici giudiziari in "RIVISTA SPERIMENTALE DI FRENIATRIA" 1/2011, pp 53-74, DOI: 10.3280/RSF2011-001005