Guelfi, Gian Paolo (Author)
This paper is about the first five years of the ‘revolution’ that took place in the psychiatric hospital in Arezzo under the direction of Agostino Pirella (1930-2017). The author worked there as a psychiatrist since 1971, and since 1974 he started the mental health service in the Valdarno Aretino area. The condition of the inpatients in 1971 was miserable, and a radical change was needed. A new director and a new medical staff was recruited by the administration to respond to such challenge, with the goal to close the asylum and to implement mental health services on the territory instead. Pirella draw the way to be followed: start from the bottom, avoid physical restraint, aim to open the doors of the wards and break down walls and fences. The inpatients were encouraged to participate in the enterprise, and the meetings (general hospital meetings and ward meetings) were the foundation and the visible expression of their involvement into the process. A very careful attention was paid to what in the policy jargon was called the contextuality of the action inside (to go over the hospital till its closure) and outside (building the mental health services on the territory). Both goals were successfully and committedly pursued till the actual closure of the hospital in 1991.
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