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| [home]| Department: Mental Health Department | Operational Units | Programmes | Associations | Social Coops | History | |||||
Programmes
The programmes presented here are carried out directly by the Mental Health Department's OUs, either alone or in collaboration with other actors/agencies, and can involve all the organisational components of the MHD in transversal fashion. In each OU/service, one or more operators are designated as referents to participate in the meetings and coordination at the departmental level. These coordination mechanisms help create a common intent regarding the main issues involved and contribute to the continually improved quality of the programmes themselves. Some programmes were first initiated by the MHCs in the 1980s in order to deal with very general problems and issues, and then received a major new impetus and focus with the creation of the Healthcare Districts in the 1990s, while other projects have a more limited duration, and are implemented by one or more OUs, or by the MHD Adminstration staff. District Mental Health PortalsPursuant to Italian Law 328 (2000) for the creation of a fully integrated
social welfare system, the Friuli Venezia Giulia Region passed Regional Law
6/2006, which allocated funds for a "citizen's income" that
guarantees equal opportunity for all of the Region's inhabitants. Micro-areas Micro-areas is an experimental programme begun in 2004. Its aims are: verifying
the state of health of residents within a specific and limited area and the
practices of all the healthcare operators in that area, beginning with GPs;
guaranteeing the right of access to services and the right to health; evaluating
the appropriateness of responses and identifying waste; evaluating the risk
of abandonment and medicalisation which transforms every human condition into
an illness, and determining the level of full response by all the actors within
a given area, from the healthcare operators to the needy citizen and his neighbour.
Starting from the grassroots level with the participation of local citizens,
Micro-areas seeks to enhance social wellbeing, providing the local population
with all of the resources, skills and opportunities of the healthcare system
and working towards a fuller integration of the healthcare and social welfare
systems, thereby fulfilling the Local Healthcare Agency's mandate in
a more complete and equal way. It therefore seeks to create a system of synergies
and integrations around the person in need in order to compensate for the
absence of responses, delays and lack of continuity. By working directly with
the local population it becomes possible to revive and animate blighted urban
areas, foster aggregation and generate continuity.
Each Healthcare District (4) has 2-4 microareas, with 1200-2500 persons in each area, resulting in a full cross-section of the population of the City of Trieste in terms of economics, age, ethnic origin etc. Children and Adolescents Mental Health Department A group of operators from the various MHD OUs works in collaboration with
the District teams responsible for children and adolescents:
Early intervention for psychosis in adolescents and young adultsMental Health Department This prevention project for the early recognition and network intervention on young people with the onset of psychosis provides for the involvement of all of the actors in the young person's life: friends, family and services. The project's activities are threefold:
In addition to direct actions aimed at the young person with the onset of
psychosis, the recognition phase also seeks to involve operators of the social-healthcare
services (including the Dependency Department) and associations/groups in
the community. The goal is to provide all collaborators with the knowhow necessary
in order to recognise the onset of psychosis, with subsequent referral to
the services. Young People with Eating Disorders Women's Mental Health Project The prevalence of Eating Disorders among young people; the very negative
impact of this Disorder upon the person involved and their family; the lack
of early diagnosis; the difficulty in offering a coordinated and coherent
response and the resulting referral to the private sector or to services outside
of the Region: all of these factors led the Local Healthcare Agency Triestina
n. 1 to deal with the problem of Eating Disorders in a much more capillary
and integrated way. A multidisciplinary workgroup was therefore created in
order to establish a network that would make for a much greater collaboration
and interaction among the various professional figures within the Healthcare
Agency, and between these professionals and other healthcare and social welfare
agencies operating within the Province of Trieste. Persons with Handicap(s) Residency and Rehabilitation Service Operators from MHD OUs work closely with the District teams assigned to this area to promote collaboration and exchanges within the community for persons with mental/physical handicaps. In particular, the programme provides for counselling, family programmes and crisis support. Elderly persons in need of assistance Mental Health Department The programme aims at reducing/avoiding the risk of institutionalisation for elderly persons, especially if they live alone, have economic difficulties or are weak or vulnerable due to physical and mental problems. Operators intervene on a case by case basis and in widely diversified situations to carry out deinstitutionalisation programmes within nursing homes and other structures for the elderly, or to plan and implement prevention programmes. The programme seeks to improve:
GPs as "health tutors"Mental Health Department The programme, which was first begun as an experiment in 1995, today constitutes a standard tool for improving the general health of MHD users who also have major medical problems or who, due to their mental disorder, neglect their own health or risk being ignored/overlooked by healthcare services. In collaboration with GPs, the programme seeks to:
Improving care for persons with mental disorders and substance dependency Mental Health Department Dependency Department Mental disorders are often complicated by dependency on drugs or alcohol,
and viceversa. For this reason, the MHD and Dependency Department (DD) are
committed both to coordinating their existing resources and services, and
developing new approaches and workstyles that overcome rigid and often irrational
mandates, and are based on the interchangeability/complementary support of
equivalent professional figures working in a borderline area of mental-social
distress, especially among young people.
Work in PrisonMental Health Department This service was established in 1979, in order to provide prevention and care for persons suffering from mental distress/disorders during incarceration. Its aims are to:
It is especially important to note that the services do not limit their activities to specialised or consultancy services, but seek to respond to a wide range of needs of incarcerated persons with mental disorders, including:
The service can also recommend that the competent magistrate authorise "house
arrest" for inmates in a MHC. This alternative to incarceration has
proved itself to be extremely valuable for carrying out therapeutic-rehabilitative
programmes and for avoiding incarceration in a forensic hospital (in the last
20 years, the average number of persons from the Province of Trieste incarcerated
in a forensic hospital has not exceeded .5 per year). Work with familiesMental Health Department The programme was begun in 1987 in order to deal in a more structure, systematic way with the emotional problems and practical difficulties experienced by persons with a family member who has a severe mental disorder. Its main aims are to:
In addition to the activities of each OU, each year the MHD offers an information programme of ten weekly thematic meetings. The meetings are led by service operators and provide an in-depth examination of the issues involved, in the belief that self-help and participation of family members contributes to better outcomes in the therapeutic-rehabilitative work. During the course of meetings evaluation/self-evaluation questionaires are presented, as well as informational literature. The programmes are generally reserved for parents of users, but other family members can also participate. Recently, a more intensive programme for the parents of young people experiencing the onset of illness has been created, with parents being encouraged to join the self-help group "We together" after completing the course. Foster Homes for AdultsMental Health Department The project, which was inaugurated in Trieste in January, 2006, places adult users of the MHD in foster families. This practice, which is widely used internationally, derives from the tradition of pilgrims being hosted by local families in Geel, Belgium, which dates from at least the 7th Century A.D. The aim is to construct new social relations and promote the integration of persons in difficulty, while involving the community in therapeutic proceses and creating a new culture based on inclusion. The programme has strict guidelines regarding the candidates for placement, the characteristics of host families and their reimbursement, insurance for both guest and host families, etc.. The host family is chosen on the basis of informal discussions with the project team and undergoes a period of preparatory training. The family is not asked to function as a professional operator but to express its natural affection for the person they are hosting. During the period of "fosterage", the host family continues to be supported and aided by the project's multi-disciplinary team. Healthcare Budget - Personalised Therapeutic-Rehabilitation Project"Cantieri Sociali" - Pavilion M The Healthcare Budget Programme - Personalised Therapeutic-Rehabilitation
Project is for persons in contact with the MHCs who need a personalised rehabilitation
programme in order to be able to fully exercise their fundamental rights (health,
housing, education, training, social relations and employment). The Project
is aimed at persons with complex needs and has a duration of a maximum of
48 months. It provides for the passage from one empowerment programme to another
and/or the conclusion of the programme itself. For persons with particularly
serious personal/social problems, the healthcare budget can be extended; however,
such an extension must be accompanied by a change in goals and the development
of new activities. Self-help programmes Via delle Beccherie 14/bTel. 040 365 687 Over the past ten years, many self-help programmes have been developed which promote the participation of service users in clubs and associations. Participants are primarily young people who have/are experiencing difficult personal, family and social situations and who may therefore benefit from the forms of solidarity and socialisation provided by such groups. The main aim is to rediscover a sense of participation, breaking one's isolation and discovering the social dimension of the psychiatric problem. Each group is made up of persons with different backgrounds who together experiment with innovative forms of social solidarity that include musical, literary, ecological and sports workshops. Each year self-help groups organise training courses and encounters to increase self-awareness concerning not only personal problems, but also personal rights, and achieve empowerment in interpersonal/social relations. Specific groups for "people who hear voices" and "writing workshops" are also a feature. In recent years, sports activities have been become particularly important (see: Women's Mental Health Project, Club Zyp, Polisportiva "Fuoric'entro", Cagipota-Kazipot and "Luna e l'Altra") Women's Mental Health Project (District 2 - Family Counselling Centre) The project is a mental health prevention programme for women at risk, which also promotes general healthcare. The interventions deal with problems and difficulties that call for a wide range of responses and involve different disciplines and professional roles (and therefore operators from different services), with the use of informal and self-organised community resources (women's groups, associations, etc) whenever possible. The Women's Mental Health Project works alongside the Family Counselling Centre on particularly delicate issues, such as:
Work groups made up of operators from various MHD OUs are organised to deal with these problems through discussion and cultural activities, and projects and practices integrated with the Family Counselling Centre and other actors. The responses focus on health rather than illness, and provide multiple forms of support and specific services in order to promote the recognition and awareness of each woman's own lifestory, resist the medicalisation of needs and provide opportunities for emancipation from situations of illbeing and suffering. "Stella Polare" Project (District 2 - Family Counselling Centre) A programme for immigrant women who are victims of violence and sexual exploitation,
which implements the provisions of Art. 18 of the Immigration Act ("social
protection" of victims of human trafficking and exploitation for sexual
purposes) and is financed by the Equal Opportunity Department (Presidency
of the Council of Ministers). The Project is managed by the Committee for
the Civil Rights of Prostitutes, in collaboration with the Local Healthcare
Agency and the City of Trieste. The main goal is to free immigrant prostitutes
from all forms of coercion, aiding them in denouncing violence and exploitation
and providing assistence to immigrant women involved in street prostitution
or, in any case, who are victims of violence and exploitation. The project
uses a mix of healthcare, psychological, legal and relational approaches/interventions
which, in combination, provide "social protection". The social
protection programmes are organised and run by a team of the Committee for
the Civil Rights of Prostitutes, which consists of a director, two educators
and a cultural mediator, and also utilises healthcare/social operators when
necessary.
"Amalia - Special Phone" ProjectToll-free number: 800 846079 In Trieste, there is a substantial population of elderly (and very elderly)
persons who often live in conditions of solitude and social isolation. Historically,
Trieste has also had a suicide rate well above the national average (from
1986-1996 >22/100,000), and which is closer to the rates in Central European
countries. To deal with this situation, in 1996 the MHD, together with the
Local Healthcare Agency, the City of Trieste and a private call-centre (Televita
srl) decided to start-up a prevention programme aimed at reducing the social
isolation of the elderly and suicidal behaviours.
Elderly persons are generally involved in the Project at the request of families, operators or friends and acquaintences. The elderly person is contacted on a daily basis by Televita operators in order to evaluate health conditions and needs, and activate responses (home visits by volunteers in order to help with daily tasks; involvement of GPs to verify drug therapies; contact with pharmacies for the home delivery of medicine, etc.). As of December 2004, after 5 years of activity, 2344 elderly men and women had participated in the Project. During the same period, lonely deaths dropped markedly, from 19 in 1999 to 7 in 2005. "Alzheimer" ProjectMental Health Department With a project called "Can a family support network reduce the family burden for Alzheimer", the Local Healthcare Agency wanted to create an integrated services network which, utilising the Districts, would support patients and their families in dealing with the problems related to this serious illness. Particular attention was given to training courses, first for operators and then for families and caregivers, and the production and distribution of informational material. The basic conviction behind this initiative is that providing strong support to families/caregivers can reduce the consequences of dementia. Collaborating with the Districts are GPs, the MHD and Psychiatric Clinic, as well as the Trieste Social Services and various associations, especially the "De Banfield Foundation", which was already active in this area. The project is experimental and was financed for the first 3 years by the Health Ministry. Services can be requested in any of the 4 Healthcare Districts. "Cassiopea" Theatre/Crafts Workshop Project Via De Pastrovich 1 The theatrical group was founded in 2001, as an offshoot of the training project for women suffereing from mental disorders/distress "Passing Through". It produced two plays: "Passing through" and "Women's Circus", which were presented in various cities in Italy. The project also sponsored a "Body Expression and Theatre Workshop" for both Service users and local women, which aimed at stimulating the rediscovery and valuing of women's bodily image and being. The theatre group, which is currently being converted into a coop, also has a workshop for dressmaking and costume design for Service users. "Academy of Madness" Theatre Workshop Project (Polytechnic) The Academy of Madness was founded in 1976, during the height of the deinstitutionalisation experience, by professional madmen and aspiring actors. Over the years it has presented more than 50 theatrical productions, organised congresses and made numerous films, videos and documentaries, also in collaboration with the Italian state television, RAI 3. The Academy offers its "mad actors" the possibility of sharing artistic practices and existential projects, life itineraries and transformations of the day to day, ways of experiencing suffering, pieces of a journey taken together, experimentation, departures and returns, life-stories, knowledge, experiences, practices, theories and techniques, theatrical methods and research, quality processes and products and the production of ideas. It is a place where people invent in order to live, and live to invent. It is a polyphony of identities in which the undiscovered diffused intelligence of individuals can give value to mutual differences. It is a common search for taking care of oneself, places, theatre, others. It is coming together, listening, telling; narrating the ability to exist and produce synergies through diversity, telling our stories and putting them on stage. "Radio Fragola" Social Communication Project Via De Pastrovich 1 This radio station, which is accredited with the MHD, first went on the air from the San Giovanni compound in 1984. Its programming focuses on social communication and prevention, and fights against stigma and social exclusion through the first-person accounts and involvement of its guests and collaborators. As part of "La Piazzetta" social coop, it promotes social integration programmes for young people in difficulty. |
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