COMPREHENSIVE COMMUNITY CARE WITHOUT LONG-STAY BEDS IN MENTAL-HOSPITALS - TRENDS FROM AN ITALIAN GOOD PRACTICE AREA

Despite the scientific evidence that long stays in mental hospitals ar e clinically deleterious, inhumane and probably not cost-effective, th is Practice still occurs in most Western countries. The continued use of long stay beds in mental hospitals is a policy decided by many auth orities, including psychiatrists. Alternatives to the mental hospital exist and may limit the use of hospital beds through comprehensive com munity care that also includes proper residential provisions. Alternat ives may also decrease, but not impede the tendency to chronicity in s ome patients, who become long term users of these community services. Italy passed a law in 1978 prohibiting admissions to mental hospitals and encouraging the development of community care. In South Verona, It aly, the policy has been properly implemented and evaluated. Data from the case register and intensive studies of a cohort of patients will be used to show that long stay hospitalization can be discontinued whi le meeting the needs of the most severely handicapped patients. Implic ations of South Verona's experience for future training of psychiatris ts will also be discussed.