Barbara Capovani "was a tireless and passionate psychiatrist, I don't remember ever seeing her without a smile. She handled every situation in a competent and reassuring way, finding the best solution for everyone". A year has passed since her death, on 23 April 2023 at the hands of a patient, and the president-elect of the Italian Society of Psychiatry (Sip), Liliana Dell'Osso, remembers her with these words as she prepares, with colleagues from all over Italy, for a 'special' working day:
today, Saturday 20 April, psychiatrists will be in hospitals and clinics with a black armband
, to remember Capovani and say 'no' to violence against doctors.
The numbers speak for themselves: according to Inail, every year there are over 2 thousand cases of violence in healthcare. Six thousand in the three-year period 2020-2022, with an increase of 14% over the previous three-year period.
In 2023 alone there will be around 2300 cases, of which just as many are milder and unreported. Of all these, 34% occur in a psychiatric setting with 21% in the emergency room according to data from the medical union Anaao-Assomed. One year after Barbara Capovani's death, "despite appeals and demonstrations - states Dell'Osso - apart from circumstantial phrases, the problem of psychiatry in Italy and the safety of mental health departments and centers has remained buried under a sea of declarations without real solutions." A first measure, the psychiatrists ask, should be the abolition of the Lamorgese Circular on the ban on police intervention in emergency rooms and departments: "This rule - underlines the Sip president Emi Bondi - has disappointed the doctors and further made the management of violent patients in psychiatry wards is difficult".
Added to this are the problems of managing the emergency room, the emergency room and the residences for the execution of security measures (Rems), "mistaken for judicial psychiatric hospitals, as if law 81, which decreed their closure - notes Bondi - had never existed. In short, the role that is being given to psychiatry again as manager of aggression means that health workers are increasingly called upon to deal with all social deviance, without discrimination between those who really are. a mentally ill person who needs treatment compared to someone who is just violent." And then there is the resource node. Society "has changed, mental illnesses have grown in number, as they are diagnosed with more precision and earlier. Treatments have been revolutionized, yet resources have remained stagnant. And so - comments the Sip president - the local services are closing and mental health hospitals and beds are decreasing in the always full departments,resulting in an increasingly marked flight of personnel from the public service".
The latest request for help is the one addressed, a few days ago, to the President of the Republic, Sergio Mattarella, in a letter-appeal signed by 505 mental health workers from all over Italy, including psychiatrists, psychologists, nurses and social workers. They denounce the "disastrous" state of psychiatry services, including a lack of doctors and poor funding. Mental health services, they write, "have a crucial importance, especially for the weakest and most needy sections of the population. Italy cannot afford to watch helplessly as their regression, a process that has been underway for years, and is close to a point of no return. And we, workers on the front line, cannot afford to remain silent. The centenary of Franco Basaglia, the psychiatrist who inspired the law that half a century ago changed the approach to mental illness in our country, has been celebrated. the avant-garde in the world. What would Basaglia think of the current situation of Italian psychiatry?". To date, the psychiatrists conclude, "we have not received any response".