How does the Shalom community not receive checkups and administer psychopharmaceuticals without medical personnel

As reported in an investigation by Fanpage.it, in the Shalom recovery communitywhich is located in Palazzolo sull’Oglio (Brescia), guests live between psychological and physical violence and with consumption uncontrolled use of drugs and psychotropic drugs. But how is it possible that in so many years the Shalom community did not receive checks of the Territorial Health Protection Agency? The reason would appear to be that this community it is not accredited with the healthcare system of the Lombardy Region, but only authorized for operation. And this allows those who manage it to not having to submit to the supervision of Ats and consequently of the Region. What happens instead to all the other accredited Brescian communities?

The difference between operating authorization and accreditation

There are 22 therapeutic communities in the Brescia area. Twenty of these are accredited. How do you get accreditation? Authorization to operate is the first stage. In order to operate and provide rehabilitation treatments, it is necessary to present a request for authorization to operate. It is essential to meet certain structural requirements (sanitary, volumetric and space) and staffing requirements.

For accreditation you must have higher requirements which always concern the structure and the staff. In the latter case, for example, it is necessary to have a quantity of professional figures such as to be able to dedicate them to all types of intervention: educators, social workers, psychologists, psychiatrists, nurses. In case of accreditation, you can go to the next step: the economic contract with the Region. However, it is true that it is only possible to obtain accreditation, without any type of economic contract. And, in this way, it is possible to turn to the private market.

Accredited communities: checks

Fanpage.it, contacted some accredited structures. Giovanni Zoccatelli, president of the Bessimo Cooperative (which has seven communities in the area), said that: “Every year we have a check for structural standards, one for functional ones and another for appropriateness. These are checks involving the adequacy of sanitation, the educational qualifications of the personnel and the appropriateness of the interventions. In the latter case, it is understood that Ats checks that the interventions are appropriate to the standards set by the Region”.

And so also to the San Luigi Cooperative: “A multidisciplinary team is sent, made up of a psychiatrist, educators, psychotherapists. There are checks on appropriateness: a sample of medical records is examined and it is verified that everything written there, is appropriate to the subject”.

“Then there is a check on the functional and structural standards. Supervision checks that all the environments are up to standard and that they are suitable from a hygienic-sanitary point of view. educators provided for by the regional regulation: it is a 360 degree control “.

“We have inspections every year. This year, for example, we had 4 inspections from May to September/October. And rightly so. If there are rules, you have to respect them”. The Calabrone Community describes the same rules described by the other two cooperatives and adds that, even in their case, the checks by the Ats take place on average once a year.

The accredited communities: the administration of drugs

In movies shown by Fanpage.it, guests tell of drug therapies that they consider excessive. A completely different story from the one told to us by Zoccatelli of the Bessimo Cooperative: “The therapies are prescribed by the Drug Addiction Service which is in charge of people in the area. When a person enters the community there is also a local doctor who deals with generalist therapies”.

In the structures of the Bessimo cooperative there is no pharmacy: “We have a psychiatrist who periodically follows the patients inserted and monitors the therapy. Communities are social-health services. This means that the continuous presence of a social-health figure is not necessary The seriousness of people’s conditions may suggest that they have it, but they are additional elements to the minimum required standards”.

“In our case they are people who are able to self-administer drugs. We we keep them in suitable places to the maintenance of medicines, at various times they come and take the medicines that have been prescribed. We are not in charge of administering the drugs.”

Unlike what happens in Shalom where “the old”, i.e. those who have faced a path and are at the end of it, administer the therapy, in the San Luigi cooperative the administration it is not the property’s responsibility: “We don’t have a requirement. We have a nurse who prepares the blisters with the daily therapy that we keep in the infirmary. After that, there is self-administration with a sample in the morning, afternoon and evening based on the therapy prescribed to them by the territorial services “.

Also in the Calabrone community there is “controlled self-administration. There is a prescription and a therapeutic plan sent by the outpatient services in the area that take care of people and send them to our facilities”.

The accredited communities: the period of stay

Another questionable point is the time spent within the Shalom community. The mere fact of being authorized to function alone allows them to be able to autonomously establish the duration of the journey. Too bad this translates into endless times. The case of a guest who has lived there for the past twenty years is emblematic. And here too there is a substantial distinction with the accredited communities.

“The regional accreditation provides for 3 months for prompt reception, 18 months for specialist courses and 36 months for therapeutic and pedagogical courses. Our reality – explains Bessimo – has a bit of all types of treatment. We go from short courses that they last three months, six months, nine months, 18 months at the most. On average, in 2021 our courses lasted about nine months”.

“They are rehabilitative choices that every reality can make. Our communities offer short courses. In our case, there are also people who stay for three months or 18 months. But rarely do we get to two years. Of course, it can happen that many situations have no outlets. Then there are low-intensity courses, a type of treatment that can take longer. At most, it’s 36 months which can then be repeated based on the situation”.

For the San Luigi Cooperative, the duration of the journey is a maximum of three years: “In the event of a double diagnosis with the psychiatric one, the duration is 18 months which, however, can be extended”. However, it is certain that this duration, which as explained by other communities is imposed by law, is necessary to provide for a re-integration into society.

“In our case, at the end of the course, we get involved in work placement cooperatives. We don’t succeed with everyone: there are patients and people who manage to make certain changes even at a personality level. They manage to start a life completely different. And at the basis of all this there is also job placement. Without work, what do you do? You cannot live on assistance alone. They must be monitored for a period, but then they detach”.

Of the same opinion is the Calabrone cooperative from where they explain that a period of permanence longer than that established by the regulatory standards is excessive: “The period within the community foresees that a person must stop and use the tools provided by us. All our thoughts, however, are projected to return to the world. To relive one’s life. Interrupting life for ten years is too much. We try to insert people into the social world, to establish new relationships, which are not those of the past and which come from the circle of consumption and we try to bring people back into the world“.