by Veronica Rossi
December 29, 2022
from life”
Relatives of people suffering from psychiatric pathologies in Trieste complain of a depletion of mental health services, highlighting a decline in the functionality and opening hours of the CSMs, which, from aggregation poles, are becoming mere drug dispensers
Need help at night. Go to your reference Mental Health Center (CSM) and find it closed. Wander for three days, alone, in the city, sleeping rough. This is what happened to a boy suffering from a psychiatric illness. And not in a remote location, forgotten by the health system, but in Trieste, an international reference point for mental health, a laboratory of the Basaglia revolution.
“We have been noticing, for some time now, a degradation, an impoverishment”, he says Tiziana Tomasonivice president of‘Association of Psychical Suffering Family Members (A.Fa.So.P.) we together, which brings together parents and relatives of people with mental health problems and the mother of a young man with a mental illness. “Here we are lucky, we don’t have restraints, armored doors or cameras, the CSMs are open, but you can’t deny that we no longer have the answers we once had, even as psychiatric patients have increased.” The reference center for Tiziana’s son is that of Via Gambini – the others are Domio, Barcola and Maddalena – which has recently undergone a reduction in service, going from opening 24 hours to 12 hours a day. «This causes enormous discomfort», continues the woman, «because people feel bad even at night and not only from Monday to Friday. At the weekend, however, according to our knowledge, there seems to be only one psychiatrist available who covers all four CSMs”. Tomasoni has personally experienced the difficulties associated with the decrease in the help offered by Via Gambini. “My son had the onset of his disorder at 16, now he’s 25,” he says. «About a year ago he was ill and he needed hospitalization in Diagnosis and Treatment (SPDC), which is the department where acute care is worked on. After two or three days, once the emergency is over, he should have been sent to the reference CSM for a period, but unfortunately Via Gambini closes at night. So he had to stay more than a month in the SPDC, occupying a bed in an area that serves to treat those with crises and not for long hospitalizations ». The young man did not receive bad treatment from the operators. However, he simply shouldn’t have stayed there, but continued the treatment path in the structure that best suited his needs. Despite requests and protests from parents, the situation is not improving, on the contrary: the center, which must undergo renovations, will be closed and should be moved to a university building located nearby. “The doctor Elizabeth Pasturethe director of Via Gambini, has assured us that there will be an alternative venue», says Tomasoni, «but we don’t know yet which one it will be, because it is not certain whether the structure that was initially designated actually has all the characteristics to be able to host a CSM”.
There are also personnel problems in the center: the blanket is short and some of the already few operators have been sent to cover the shifts of Domio, Barcola and Maddalena, which remain open 24 hours. The parents had gone to ask for reassurance from Antonio Poggiana, director general of the Giuliano-Isontina university health agency (Asugi), who – they say – had assured that new nurses would arrive. Now, however, a Residence for the execution of security measures (Rems) has been opened in Duino-Aurisina, a coastal municipality a little further north, which has required the dispatch of nurses, and Via Gambini is still uncovered. «By now the CSMs risk becoming mere drug dispensers», comments the woman, «whereas before they were a place in which to embark on a rehabilitation process. It happened that the interviews even took place while walking, going to get an ice cream. The operators played football with the users, they even ate with them ». Via Gambini used to offer lunch and dinner, now only the first, in a container to take away. «We understand that they were measures to reduce the spread of the pandemic», says Tomasoni, «but now there is no longer the emergency that existed in 2020 and 2021. The impression, now, is that Covid-19 is used as a pretext”.
An innovative service, started by the previous director of the Mental Health Department, was also shelved last summer, Robert Mezzina, which had imported it from Anglo-Saxon countries: a home support, in which a team made up of a psychiatrist, a nurse, a technician went to the homes of patients in crisis, reducing the need for compulsory health treatments (Tso) and hospitalizations . For the first few days, the team went to visit the person in difficulty daily, took them out, checked their health and gave support to their families. «They told us that they had suspended the service to allow staff holidays», explains Tomasoni, «but then it was never reintroduced».
One of the characteristics of Basaglia’s method, as we know, is dialogue, with patients, but also with family members and society as a whole. Today, it seems, comparison is less and less encouraged and listening becomes rarer every day. “Mental health is life,” concludes the vice president. «Seeing that our services are taken away from us, especially the CSMs, extraordinary principals in the area, hurts. This attack is really scary. We can’t imagine having politicians so insensitive as to destroy a system that works, envied around the world“.
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