ABSTRACT
The Department of Mental Health (DSM) Rome E is actively involved in promoting preventive awareness among public psychiatric services.
In a recent survey which engaged about 800 centres we tried to explore several issues: a) who is going to conduct prevention, b) by improving the preventive paraigma, what will be the consequences for the Departments, c) what are the most important strategies of prevention, d) what preventive activities can be planned and carried out, e) what are the most important hindrances that interfere in accomplishing preventive measures.
The most significant answers were the following five: 1) global lack of trust, pessimism and sceptisism regarding operative possibilities in preventive field, even by open – minded therapists, 2) promotional activities are considered realistic goals to be achieved, 3) almost all interviewees think that prevention and mental health promotion do not regard DSM only, but involve all social health services, 4) the majority of the interviewees deems that prevention means promotion of mental health and only 1.7% think that the target has to be the early detection and early treatment of mental conditions at risk, 5) reducing of occurrence of new cases is considered a mere chimerical project.
Despite the fact that preventive culture in Italy is weak, there is strong evidence that forces us to outline the need for implementation of preventive model in the Departments. The four reasons for prevention are the following: 1) epidemiologic data, 2) the problem of saturation of psychiatric services, 3) economic reasons and 4) clinic data.
The following four strategies are needed to improve psychiatric services: 1) the managment of mental health is based on the community model and the 96continuous de-institutionalisation process, 2) the promotion of a new culture of mental health in school, 3) the introduction of brief, economic and effective therapeutic tools to treat non severe mental disorders, 4) early interventions in pre-psychotic phases and mental states at risk.
