World Mental Health Day is celebrated on October 10th. But Italy, cradle of the most powerful and successful experiment in liberating the mentally ill from the chains of psychiatry, not only systematically denies its own reform and its roots as the homeland of the rights recognized to the mentally ill but, on a daily basis, debases, weakens , defunds the public mental health service.
Since 1992, on the initiative of the World Federation for Mental Health, World Mental Health Day has been celebrated on 10 October. The day is dedicated every year to a different theme and this year the title of the celebrations is “Mental health is a universal human right”. Already in 1998 the day was dedicated to human rights (Mental Health and Human Rights was the theme of 1998) but this year the emphasis of the day is on the strong idea of mental health as a fundamental right.
In essence, it is a matter of reaffirming two aspects of this right: the right of every citizen to enjoy mental health and the right to receive treatment that restores mental health when it is compromised. Therefore, this October 10th we celebrate the right to mental health for all: for those who suffer from poverty, social exclusion, lack of access to education and health services, conditions of existential precariousness linked to every humanitarian crisis whether caused by natural events or by man, in short, for everyone, because everyone has the right to maintain their mental health.
But, also, we celebrate the rights of those whose mental health has been compromised. The right to receive humane, effective, fair and accessible care. For years now, reports from the United Nations human rights office have denounced the persistence of stigma and discrimination against people with any type of psychosocial suffering and above all denounced the systematic violation of their human and civil rights, precisely in the places that should be dedicated to their care. Let us also not forget that people who are diagnosed with a mental disorder have a life expectancy reduced by more than ten years compared to people who do not suffer from any mental disorder (1). And this reduced life expectancy is not due to the mental disorder itself but to the conditions in which these people live and are treated by health systems.
Nasser Loza, president of the World Federation for Mental Health, writes: “guaranteeing access to mental health services is an obligation and responsibility of the state… access to better living conditions, greater personal safety, food, shelter , to a house, are all needs related to mental health” (2).
These annual celebrations find a formidable multiplier both in the initiatives of the World Health Organization connected to the promotion of the Quality Rights initiative, and of the European Union which will hold a high-level conference in Brussels, hosted by Stella Kyriakides, European Commissioner for Health and Safety food. This event will bring together hundreds of representatives from EU institutions, national governments, international organizations and other interested partners to listen to experts and people with lived experience and exchange experiences of good practices.
And in Italy?
In Venice, forty-five year old Bruno Modenese died on 19 September. Spontaneously admitted to the Psychiatric Diagnosis and Treatment Service on 16 September, two days later he died of presumed cardiac arrest but the body had a fractured nose and cheekbones and cerebral edema. Two nurses are under investigation. It is not the first time and for years the violence of many psychiatric diagnosis and treatment services and of forced hospitalization procedures has been denounced.
On August 4, 2009, Francesco Mastrogiovanni, a 58-year-old teacher, after being stopped for an alleged violation of the highway code, was subjected to a manhunt, chased, captured and locked up in the psychiatry department of the San Luca hospital in Vallo della Lucania and subjected to Tso (Compulsory Health Treatment). He emerged 82 hours later dead, killed. He is tied to the restraint bed, an 82-hour agony that was all recorded by the hospital’s surveillance cameras. The video, at the request of the family, was made public.
In 2019, a 45-year-old man was found dead in the psychiatric ward of the Santissima Trinità Hospital in Cagliari. It seems that the man, who had been hospitalized for a few days, was contained and confined to his bed because he was considered dangerous.
But still.
In the psychiatry department of the Lamezia hospital, a 39-year-old man, FT, was found dead on 16 May 2016. He had been forcibly taken to the department to undergo Tso (compulsory health treatment). In Turin, a 45-year-old man, Andrea Soldi, died while the traffic police had captured him to subject him to Tso. He appears to have suffered a cardiac arrest, he was unable to reach the hospital alive. Witnesses describe traffic policemen who grabbed him and held him by the neck until he fell to the ground lifeless. In Carmignano Sant’Urbano (Pd), a thirty-three year old boy, Mauro Guerra, was killed by a carabiniere during a Tso. When some carabinieri arrived at Mauro’s house, he was frightened and attempted to escape. One of the carabinieri shot and killed him. Why did the police intervene and not the 118 health workers? Finally (but unfortunately this is not the end of these episodes) a 39-year-old man, Massimiliano Malzone, died during a Tso: he had been admitted to the psychiatric diagnosis and treatment service of the Sant’Arsenio hospital in Polla, in the province of Salerno .
But we could continue because the list is long.
Maria Grazia Giannichedda wrote in the Manifesto of 24 May 2022: “Violent psychiatry, which has never gone out of play, is taking over again. The obsession with control returns in the name of safety which has never avoided “accidents”, as they used to say in mental hospitals; the misery of crowding, exhausting shifts, neglect of legality and respect for people is spreading, partly thanks to Covid. But when the SPDCs function as 16th-level mental asylums it is because the local clinics usurp the name of mental health centres, they are hasty places of control that ignore people’s lives and feed the circuit of structures in which to put them. It is necessary to invest in the transformation of this service system to combat violent psychiatry” (3).
Here, today Italy, cradle of the most powerful and successful experiment in liberating the mentally ill from the chains of psychiatry, not only systematically denies its own reform and its roots as the homeland of the rights recognized to the mentally ill but, on a daily basis, debases , weakens, defunds the public mental health service. Undefended and increasingly violent hospital services, territorial services weakened by the necessary staff and the private system of cooperatives and residential structures that expands and devours one of the most well-known and celebrated jewels of Italian healthcare.
On 10 October this year, let us remember the two rights celebrated by World Mental Health Day: the right of every citizen to enjoy mental health and the right to receive treatment that restores mental health when it is compromised. Let us remember that these rights are too often violated in our country. Let’s remember that more than celebrations we need fights by workers and families to defend those violated rights. Fair fights that must not be occasional but continuous and above all they must be determined and tough.
by SOS Healthcare