ABSTRACT
The pilot experiences at Gorizia and Reggio Emilia had eventually been curtailed by conflicts that arose with the local authorities. What developed at Trieste in the 1970s was by contrast a sustained experiment which enjoyed substantial or at least continuing support from local administrators, and which by the end of the 1970s had developed into a showcase demonstration of what alternative psychiatry could accomplish in practice. Trieste had gained attention all across Europe, and was identified as a model to be studied and perhaps emulated elsewhere (WHO 1980). In a grand gesture the mental hospital at Trieste was eventually phased out and closed; the whole experience figured prominently in the public discussions, professional debates, and mass media coverage leading up to the new mental health act of 1978.1 In 1971 Basaglia was invited by the provincial administration of Trieste to reorganize the local mental health services. Public psychiatry at that time was centred almost entirely in the large mental hospital, which dated back to the beginning of the century and in the late 1960s contained over 1,200 inmates, most of them compulsory admissions. Basaglia was able immediately to hire new staff members (the addition of ten new psychiatrists almost doubled the number of physicians, and these were joined by a number of students and volunteers) and set to work following some of the same initial steps that had been taken at Gorizia. Ward doors were opened, isolation rooms and restraint-beds eliminated, and shock therapy abolished. But from the beginning the idea was to pick up from where the experiment at Gorizia had ended. There was now an emphasis on planning for community-based care; the goal was not to improve the
At Trieste we can show that we have destroyed a hospitalFranco Basaglia, December 1976
(quoted in Elkhaim 1977:157)
hospital but to move outside and beyond it entirely. Hence the work at Trieste involved both changing the hospital environment and beginning extramural work in the surrounding community-and building links between the two.
