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The Paradox of the Waiting List to Enter REMS: A Delay in the Execution of Magistrates' Orders or a Search for a Better Way to Treat Mentally Disordered Offenders? Reflections Three Years after the Closure of Forensic Psychiatric Hospitals in Italy

Author(s): Marco Zuffranieri , David De Cori, Enrico Zanalda

In Italy, Public Law n. 81/2014 promotes innovative, recovery-oriented, rehabilitative treatment for people with mental disorders who have committed a criminal offense, without criminal intention, but who are, nonetheless, regarded as socially dangerous. A relevant innovation was in the transfer of responsibilities and management of care from the Ministry of Justice to the Ministry of Health. The reduction of the number of beds during the transition from Forensic Psychiatric Hospitals (OPG) to Residences for the Execution of Security Measures (REMS) led to a waiting list; the intention to carry out community projects on patients who already had a REMS entry order led to friction between the legal system and the health system. Based on the experience in the Piedmont Region concerning the handling of mentally disordered offenders, the factors influencing the contrasts between the legal system and the health system have been examined: management of facilities by the regional health system and governance of the security measures by the Judiciary, extensive use of diminished responsibility, functions of the old OPGs not passed on to the REMS. The experience of managing the waiting list in Piedmont has revealed ways of dealing with these critical issues, but there is still a need for further organizational and, above all, legislative innovations.

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