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Is there no psychiatric bed in Italy?

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Hello. I am probably the first Japanese to be hospitalized in Italian psychiatry (if any Japanese were hospitalized before November 2020, please contact me softly). Therefore, it can be said that I have some knowledge of the reality of “Italian psychiatry”.

To conclude first, the information that “there is no psychiatric bed (psychiatric hospital) in Italy” is incorrect. I was certainly hospitalized in the “Italian Psychiatric Department”. There is quite a lot of false and exaggerated information about this category.

What does not exist in Italy is “manicomio”

Manicomio is translated as “psychiatric hospital” and is a form of psychiatry that once existed in Italy. Manikomio disappeared from Italy in 1996. Manicomio is a psychiatric hospital. There are no other departments (internal medicine, surgery, ophthalmology, etc.) in Manicomio. Manikomio was a closed environment and there were many scandals. Some were imprisoned by Manicomio without a psychiatric diagnosis because they were orphans. Electroconvulsive therapy was used as a punishment rather than a treatment. The electroconvulsive therapy was devised by the Italians, and there are pros and cons.
Therefore, “there is no psychiatric hospital in Italy” is correct in Manicomio (= psychiatric hospital).

“No. 180 law” which forms the basis of Italian psychiatry

The law created by a psychiatrist named Franco Basaglia is called Law No. 180, commonly known as the “Basaglia Law”. The law stipulates the abolition of Manicomio and SPDC, a psychiatric department I was hospitalized in (described later).
The law also describes the method of “mandatory treatment (TSO: (trattamento sanitario obbligatorio)”. TSO is equivalent to medical protection hospitalization and treatment hospitalization in Japan. It states that the implementation requires the permission of two psychiatrists. In the situation where TSO is performed, “necessity and urgency that cannot be postponed” is a mandatory item. The condition is that the patient refuses treatment (rifiuti il ​​trattamento) and that he has no choice but to be hospitalized (non sia possibile prendere adeguate misure extraospedaliere). It may be extended depending on your condition. It is related to the contents of Article 32 of the Italian Constitution.
I will quote below.

La Repubblica tutela la salute come fondamentale diritto dell’individuo e interesse della collettività, e garantisce cure gratuite agli indigenti. Nessuno può essere obbligato a un determinato trattamento sanitario se non per disposizione di legge. imposti dal rispetto della persona umana.

The translation is as follows.

The state protects health as a fundamental right of the individual and for the benefit of the community and guarantees free medical care to the poor. No specific health treatment may be required except by law. The law cannot violate the restrictions imposed by respect for human beings under any circumstances.

Quote: Italian Senate https://www.senato.it/istituzione/la-costituzione/parte-i/titolo-ii/articolo-32

What is SPDC (Servizio Psichiatrico di Diagnosi e Cura)

Now let’s talk about SPDC, which is the basis of this article. SPDC stands for Servizio Psichiatrico di Diagnosi e Cura and is translated as “psychiatric service for diagnosis and treatment”. Although it is a small detail, the definite article uses lo. Since SPDCs are located in general hospitals, treatment is provided in collaboration with other departments when necessary. So, for example, if you have an eye disease and you run out of medicine, you can see an ophthalmologist while you are in the hospital. There are 318 SPDCs throughout Italy and there are 3981 inpatient beds. For reference, there are 330,000 psychiatric beds in Japan. This is one of the highest standards in the world.
According to the 180th method (Basaglia Law) I wrote earlier, the limit of SPDC is set to 15 beds. The SPDC in the hospital I was in (S. Salvatore Hospital) was on the first floor of a double-decker. When I took a walk in the ward, there were only 14 beds, so the nurse said, “This psychiatry is too small. I’m sure there are other psychiatric beds in the hospital. The second floor is for seriously ill people and imprisonment, I think” When I asked, “Is this a psychiatric sickbed for people?”, I was really surprised because he said, “The only SPDC in L’Aquila is these 14 beds. The second floor is another ward.” That is a feat that is impossible in Japan. I thought that there were many people involved in psychiatry (medical workers, patients, etc.) in L’Aquila due to the impact of the earthquake, but that was not the case at all.

Illusions of Italian psychiatry

In fact, Italian psychiatry is not a special place. There is no world-leading, amazing breakthrough treatment, no great medicine to cure the disease in an instant, no great facilities and treatment like a luxury hotel. is not. Some people seem to have the illusion that Italian psychiatry is a heavenly place, but that’s not the case. But it wasn’t a bad place. The hospital is clean, the food is delicious, the examination is polite, I can interact with the patients and I have nothing to complain about. I am deeply grateful to them for providing the best medical care for free.
Not only in Italy, psychiatry is a place where people who need it go. It’s the same as going to the hospital if you get the flu, and if you get sick, go to a psychiatrist, that’s all and that’s it.

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