Bunches of flowers on the place where on Sunday the two children and the elderly were killed in Ardea – Ansa
Professor, what is your idea of the Pignani case?
Unfortunately – declares Alberto Siracusano, Professor of Psychiatry at the University of Tor Vergata, member of the CEI mental health table – it is dramatically true that these tragedies can happen where situations of emptiness are created with respect to mental suffering.
In other words, the sick person was left solo?
It would seem so, but I would like to avoid the usual summary process at the institutions …
What do you mean?
It’s easy to blame someone while the most important thing – besides helping survivors – is understanding what went wrong, why it doesn’t happen again.
Let’s start with the Tso, still controversial: was this a Tso case?
Look, it will be difficult to respond quickly. Surely we must ask ourselves about the Compulsory health treatment, as it is a 1978 instrument that needs to be modernized. It has some critical points: at the base there are three elements, a situation of important clinical acuity, the acceptance of therapy, which in the case of a mentally ill person is not taken for granted; the fact that there are no other conditions of care. Tso arises before informed consent, in which the person self-determines and chooses his own path of treatment, but while a cancer patient can refuse radiotherapy, it is not so easy to recognize informed consent in psychiatric pathology, in which it is not always the case. person is aware of what he needs. That is, we risk suspending his rights or not giving him the care he is entitled to.
But people wonder why a dangerous person goes for a walk with a weapon …
Psychiatric illness and danger are not scientific evidence but a stigma. Psychiatric services must not exercise custody but treat people: it must be reiterated, also in this case, that it is necessary to treat those with mental suffering by putting the NHS structures in a position to face and offer the necessary treatment paths. Otherwise – I say this with the utmost respect for the victims – it is a summary trial of a patient.
He will understand that not everyone will be satisfied with this answer.
I understand that in cases like this one seeks the blame, but I see an isolated family and public services – in which there is a clear lack of resources, of psychiatrists and nurses – that have not been able to identify a need and respond to it. Unfortunately, there are people who escape the mental health departments and even in this case it has not been adequately cared for who was to be treated.
Should we review Law 180?
Undoubtedly, if we make the equivalence between psychic disorder and social dangerousness and we lock everyone inside asylums, we will be able to feel calmer, but we have already witnessed in the past the drama of what an asylum means. Putting the Basaglia law on trial, as it is happening, is not the solution. The problem is, if anything, that of having the adequate resources to apply the treatment pathways and not take a step back into the past, a trend that too often takes over in these cases.
What is the CEI table doing?
We have worked on mental health risk factors, also to help operators deal with problems; now one of the concerns is not to leave people alone and to find new, more effective forms of assistance thanks to telemedicine and telepsychiatry.