Mental health interventions in Italian prisons: are we ready for a new model? Suggestions from the Parma experience.

Mental health interventions for Italian prisoners with mental disorder remain a problematic issue, despite radical changes in psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. Indeed, prison has increasingly become a place of severe psychological distress, where also serious mental illnesses sometimes occur. In this contribution, we commented on the recommendations recently proposed by the Emilia-Romagna Region on how structuring mental healthcare interventions in all regional jails. Moreover, starting from the findings reported in recent epidemiological studies examining the prevalence of mental disorders in Emilia-Romagna prisons, we proposed a new treatment model for mental health and pathological addictions in jail, which took into account the current incidence of inmates with severe mental illness, psychological distress due to incarceration, and substance use disorder. Perhaps, this new intervention model (specifically centered on clinical psychology and case management by intramural mental health professionals) requires a vision able to overcome the classical "medical-centered" approach, which still too often permeates many sectors of public mental healthcare services. In our opinion, if we decide to look at the moon, we shouldn't dwell too much on the finger pointing to it.