Barbara Capovani and the 45 years of the Basaglia law

ftonight from 8 pm in many Italian squares, to remember Barbara Capovani, the psychiatrist from Pisa killed by one of her ex-patients. A “severely problematic” subject entrusted to her by the Judiciary who, upon leaving work, attacked her with unpredictable violence. Exactly 45 years after the approval of the Basaglia law, on 13 May 1978, the professional and scientific societies demonstrate. «Not because the law is rewritten but because the narrative of psychiatric assistance in our society is rewritten», explains Claudio Mencacci, psychiatrist, President of the Italian Society of Neuropsychopharmacology.

The murder of psychiatrist Barbara Capovani is (also) gender violence

«It is necessary», continues Mencacci, «because society has changed and it is wrong to superimpose scenes from Someone flew over the cuckoo’s nest to the present. In ’78 people’s civil rights were at stake. Today we are faced with cases of violent people, and I don’t deliberately call them patients, dumped on local services”. In other words, people who have committed a crime and who «have passed through the too loose meshes of the partial mental defect». As, the doors of the prison do not open for them but those of psychiatrists and therapists: professionals of care, not of custody.

Professionals overwhelmed by demands for social control that cannot concern them. And whose safety, as the news shows, is at risk. “We must also talk about gender violence» continues Professor Mencacci. “The operators are the first victims precisely as women, because their authority is not recognized by the subjects they assist”.

To remember the “total dedication to the work” of the psychiatrist, but also his physical frailty (“You were so tiny, with that slender little body of yours”), her husband Michele Ballandi in the post above.

From the Basaglia Law to the Rems

If Mencacci doesn’t talk about it, so do modification of the Basaglia law someone has in fact spoken.

The famous law 180, closing the sleeves, denied the equivalence mental illness-social danger. It was a cultural revolutionstudied and emulated around the world.

Instead it was with the law 81 of 2014 that the judicial psychiatric hospitals were closed (The Opgwhich the former President of the Republic Giorgio Napolitano had defined as “extreme horror” and which were controlled by the Ministry of Justice and not by the Ministry of Health like civilian asylums).

The risks of our psychiatric care system

Since then, each region has had to undertake to take care of its own psychiatric-forensic patients. Thus began the rush to build Rems (Residences for the implementation of security measures) residential health facilities with no more than 20 beds and an ideal point of arrival for widespread and humanized assistance. In reality, structures built with physiological regional differences, with inadequate availability and not suitable for everyone.

The perpetrators, explain the Italian Society of Psychiatry, can thus remain “free” for months waiting for the place in Rems. And at the same time they come entrusted to the “supervision” of health facilities – such as Mental Health Centers – which do not have the capacity to control violence and are constantly exposed to risk. There are hundreds of reports of violent events every day, but thousands are unreported. The impossibility of intervention and response also on the part of the relevant bodies, namely the judiciary, police and carabinieri, is obvious.

How to “manage” non-attributable violent people

From the OPG reform law, they do not yet exist, then, Therapeutic-rehabilitative services and pathways differentiated capable of guaranteeing care but also respect for the penalties deriving from the recognition of particularly serious crimes committed by violent subjects.

“It so happens that violent people are followed in the same circuits that work with the impulsive adolescent or the elderly with involutional depression”, continues Mencacci. «Woe to go back, therefore, but we need an adjustment of the laws that allow one better management of these individuals who, I repeat, are not necessarily sick».

The question is to change the legislation for people with mental disorders (psychotic antisocial) who commit crimes and who, more and more after the closure of the Opgs, they become unaccountable. One solution may be openness in some prisons of specialized sections. This is foreseen by the appeal made by 91 directors of the Mental Health Departments in an open letter addressed, among others, to the President of the Republic Sergio Mattarella.

Barbara Capovani was working on a project on the subject

But Capovani herself had been the promoter of a project for a few weeks to «establish a permanent laboratory for the analysis of the critical aspects of the current system management of non-attributable psychiatric subjectsof the prison system, of the hospital structures and of the Rems”.

It is Mencacci who does not miss the opportunity to reiterate it: if there is a weapon in the hands of therapists it is prevention. Prevention in schools, a psychological service available to postpartum women and a National Agency for Mental Healthwhich coordinates the indispensable activities to meet the mental health needs of the country, would help to reduce the number of subjects in need of psychiatric assistance.

The demonstrations in memory of Barbara Capovani in Italian cities

Tonight’s demonstrations, called with the support of the Provincial Orders of Doctors and the Italian Society of Psychiatry (SIP), with the support of other professional and scientific societies, aim to raise awareness among the population and institutions on the issue of violence in healthcare workplaces and in particular in environments dedicated to the care of those suffering from mental disorders. The cities of Milan, Turin, Bologna, Cagliari, Palermo, Rome, Teramo, Ragusa, Naples, Genoa, Bari, Perugia, Catania, Syracuse, Bolzano, L’Aquila, San Benedetto del Trento, Messina are involved.

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