by Andrea Angelozzi
23 MAG –
Dear Director,
now that the emotional wave for the tragic death of Barbara Capovani has subsided, as widely expected, nothing has happened. The Minister has appointed a select committee which has produced a series of groups that will work on various issues. With the best intentions and the competence of the members of the Table, one cannot fail to note that its composition is already the impoverishing translation of the concept of mental health into that of psychiatry and that the works have advanced into the alleys of infinite times for any provision .
In mental health, since time immemorial every government has created tables that produce sub-tables to always re-examine the same problems, as if the services had been created yesterday and it has not been known for years what the existing problems are and what the minimal corrections to work with dignity.
But by now this creation of working groups is a usual style which give the illusion of participation in decisions and which in reality will produce after a long time only precious documents which will not be followed by anything. It is an eternal “we are working on it” which risks being the alibi for not changing anything.
In the meantime, the ceiling on personnel expenditure remains, the Ministry or the Regions have not indicated any provisions relating to resources, and no ideas on how to deal with the curious problem that in Italy there are as many mental health models with related organizations and resources as there are the Regions, and that, in each Region, each ASL is also a separate sub-model. Law 180/78, which we continue to defend, has actually declined in a universe of fractals, which continue to develop autonomously in the fragmentation, pace of people’s destinies.
Even the hypothesis of revising the problem of responsibility relating to the position of guarantee according to which in the end it is the psychiatrist who is accused of the crime committed by his patient, was quickly set aside. No one, apart from Euro Pozzi in a recent letter to the European Journal of Psychoanalysis, has mentioned the problem that the Capovani affair raises.
Years ago the murder of an educator by a patient, in the face of the non-imputability of the murderer, led to the conviction for “murder” of the doctor who had seen him in counseling, by virtue of his position of guarantee. In the Pisa affair, a psychiatrist is killed by a patient, thus re-proposing a similar situation, but posing a problem that reveals the fragility of the legal system. In this case, in which whoever holds the position of guarantor is also the victim of his or her own patient, the surreal situation is created whereby the rigorous application pursuant to art 40 of the criminal code should lead to hypothesize the crime against the doctor, giving shape to the new improbable case of “manslaughter of oneself”, and saving the tragedy from adding insult only because it is not possible to proceed further. There is basically a surreal aspect in how the guarantee position is declined, attenuated only by the pain of the events, but it seems that nobody notices it.
Just as the agenda of politicians is surreal, capable of suggesting new paths to geometry and mathematics. Indeed, by creating new non-Euclidean and mathematical geometries where one is many, politicians ensure that the issue of mental health is at the top of their agenda … such as public health, territorial fragility, inflation, the climate emergency, the differentiated autonomy … and all the other issues that take turns making the news for a few days. It is a one-dimensional agenda, made up only of numerous topics that occupy first place at the same time, but which also suffer from the rapid turnover that chases the moods of public opinion. What reassurance can we get from this original approach to priorities?
What about psychiatrists? They assist, complaining a bit, hoping that something will happen and trying – unfortunately sometimes in the literal sense – to survive, in a daily life that is increasingly poor in resources, prospects and satisfaction. Colleagues forgive me, but I can’t help but think of certain chronic patients produced by the institution, who in the end no longer had the energy to question either the institution or their condition in a real way, thus seeking another horizon, but they were satisfied minimal reassurance and to have cigarettes.
I believe that if the good Diogenes of Sinope were around today he would wander around with his lantern looking for psychiatry.
Andrea AngelozziPsychiatrist
23 maggio 2023
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