A Study of Long-Stay Patients Resettled in the Community After Closure of a Psychiatric Hospital in Italy

Upward trend in tobacco use, particularly in women, is a reason for concern. In medical faculties, principles of prevention should be more emphasized and the students motivated for healthy life-style and to fulfill their future role in public health. The situation noted among medical students indicates that a community in Slovakia is still not satisfactory inclined towards non-smoking and a dramatic decrease of tobacco use can hardly be expected either in the near future.

Deinstitutionalization has not been pursued in the post-communist Europe until recently. The population of psychiatric patients institutionalized in the regional mental hospitals is, however, largely understudied. The aim of this study is to assess discharges of long-term inpatients with schizophrenia from Czech psychiatric hospitals and to analyse re-hospitalizations within this group. The nationwide register of all-cause inpatient hospitalizations was merged with the nationwide register of all-cause deaths on an individual level basis. Descriptive statistics, survival analysis and logistic regression were performed. 3,601 patients with schizophrenia previously hospitalized for more than a year were discharged from Czech mental hospitals between 1998 and 2012. This included 260 patients hospitalized for more than 20 years. Nearly one fifth (n=707) of the long-term patients died during the hospitalization; and discharges of 19.36 % (n=697) were only administrative in their nature. Out of 2,197 truly discharged patients, 14.88 % (n=327) were re-hospitalized within two weeks after the discharge. The highest odds of rehospitalization were associated with being discharged against medical advice (OR 5.27, p<0.001). These data are important for the ongoing mental health care reforms in the Czech Republic and other countries in the Central and Eastern Europe.

Franco Basaglia holds a special place in the memory of all psychiatric workers in Italy. Nonetheless, recollections of the radical and successful experiment of Trieste, the Northern town where Democratic Psychiatric was born, strikingly differ from the history of deinstitutionalization in other areas of Italy. This paper will explore how the Basaglian model, which implied a radical restructuring of Italian society, was articulated in localized domains, especially in relation to the restructuring of the social function of psychiatry