A proposito della Legge 180 trent’anni dopo : riflessioni su una Psichiatria che cambia (e sul ruolo dello psichiatra)

In 1978, Law 180 eliminated psychiatric Hospitals for implementing community and rehabilitative care. After 30 years, it is of interest to make the point on limits and unmet needs linked to this Law. Actually, it stemmed from social psychiatry as conceived in 60's and focused on hypothesized social determinants of chronic psychoses, paying less attention to other important variables (e.g. biological) and psychiatric domains like mood and anxiety disorders. In fact, this model was totally devoid of recent epidemiological, diagnostic, psychobiological, therapeutic knowledge, showing the multidimensional etiopathogenesis of mental disorders. In addition, the Law 180 conditioned the formation of clinical psychiatrists with this "dogmatic" reductionism with more emphasis on social aspects and less attention to clinical aspects and to non psychotic disorders. Currently, Italian psychiatrists need to regain their clinical skill, role and identity in an open-minded vision of the etiopathogenetic complexity of psychiatric disorders.