Among the many debates on the issue of how incarcerated individuals are dealt with inside penitentiary institutions, between need for custody and need of rehabilitation, this article highlights the state of the art of a specific category of people: offenders with psychic distress. Often difficult to place, as they require intervention within different areas of expertise, these individuals are deemed not to be imputable because they suffer from mental illness. They are therefore subjected to detention security measures because of social danger. This paper elaborates on the standpoints of all different ideologies, on the changes in legislation and on the recent reforms in the Italian health-care system; all these factors, over time, have marked and changed the fate of these people on a historical and cultural level. Over the years there have been changes in the places destined to this category of people, in the objectives and the requirements of confinement, in the methods of treatment, which led to the deinstitutionalization of OPG structures and the implementation of the current REMS structures. These health-care structures, one for each Italian region, aim at conducting a treatment and social reintegration program for all patients, thanks to an efficient collaboration with other health-care services of the area and with the judicial authorities.
Keywords: Prison, Rehab institution, Psychiatric expertise, Crime, Forensic psychotherapy, Mentally ill criminal.