The opening of the Residences for the Execution of Security Measures (REMS) and the simultaneous closure of Judicial Psychiatric Hospitals (OPG) has been accelerated in the last three months, after the government appointed a sole commissioner in charge of implementing law 81/2014.

The appointed commissioner, Franco Corleone, who is currently the ombudsman of Tuscany, started working in the six regions that didn’t respect the May 31, 2015, deadline for the implementation of the law: Tuscany, Veneto, Abruzzo, Puglia, Calabria, and Piemonte.

Better care for psychiatric patients

Today, 24 REMS are in operation; within two months, there will be 30. Last year, there were 240 admissions to the 24 REMS, compared to 133 patients released. This indicator shows that the idea of OPG as a place of detention, care, and custody has been transformed under REMS into a therapeutic place of transition.

Only qualified medical personnel work in REMS: psychiatrists, educators, psychologists, and social and health workers. Under the new law, the management of REMS falls to the Local Health Authority Service (ASL). The idea is to take better care of the patients. Mechanical restraint is not exercised except in the REMS of Castiglione delle Stiviere, and there only in extreme cases.

Security measures

One of the most important problems to solve is the level of security measures for REMS — some 200 requests for security features have been submitted for the facilities — and defining the patients they will care for.

Commissioner Franco Corleone suggests that to solve this dilemma by "legislative intervention to define the limits on the use of REMS for people who did not receive a definitive sentence, but only for people who got a conviction at last in the first degree of the trial."

Regarding pending trials, it is possible to prioritize care and therapy within the criminal psychiatric care setting of forced hospitalization or probation. It is important to avoid a return to the "asylum" logic that civil society has worked so hard to do away with.

The challenge is not only legal, but ethical, too, because it involves a consolidated state of mind about the ideas of punishment and care, of madness and health. The attention of the civil society and monitoring of future developments is indispensable. It is our collective responsibility.