Forensic Psychiatry In Italy: Places of Treatment

This chapter, which deals with places of treatment for the mentally infirm who have committed crimes following the closure of the Forensic Psychiatric Hospitals, is based on articles and information received from Drs Luca Castelletti and Franco Scarpa. It provides a brief explanation of the Italian judicial system with regard to persons who have committed a crime but are not guilty by reason of insanity, and the interactions of the law with the health system. It offers a review of the Residences for the Execution of Security Measures (REMS), structures for the mentally infirm who are considered to constitute a danger to society, which have to a certain extent replaced the Forensic Psychiatric Hospitals. Run by health professionals, their objective is to help these patients achieve social rehabilitation through ad hoc treatment programs. The chapter includes a review of the 2019 report on the REMS, an initial evaluation of their efficacy, patient profiles, and a discussion of the inherent problems. It also comments on the ATSMs, prison wards which accommodate persons waiting for a place in the REMS, or who became mentally ill before their custodial sentence could be executed, persons considered to be “mentally handicapped”, and those who had been sent to a criminal asylum for an “assessment of their mental health”.