Closing Judicial Psychiatric Hospitals: not guilty by reason of insanity offenders' socially dangerous treatment inside psychiatric community network: an Italian perspective

Learning Overview: After attending this presentation, attendees will better understand the treatment practices of socially dangerous offenders inside the psychiatric community network called REMS (Residence for the implementation of Security Measures). Impact on the Forensic Science Community: This presentation will impact the forensic science community by demonstrating the security measures that the new national residential network is developing to share common good practices of care. Two years after the introduction of Italian forensic psychiatric reform, the new national residential network for subjects in security measures is now trying to develop and share common good practices of care, according to the contents of the new legislation. In this work, progressive steps of assessment and care of those admitted to the REMS will be illustrated, as well as the way new scenarios may impact the role of expert judgement in the courts and their effects on forensic subjects’ referrals. Some critical points fostered by the new system, including criteria for admissions and clinical rationale for releases to lower levels of security, are discussed further in this work. Regarding risk issues, the forensic and general psychiatric network may benefit from an integration with recovery-oriented models, looking at the risktaking paradigm and strength model.1 Concept of risk, in this manner, is viewed as life challenges in prosocial goals, real social integration, autonomy, advocacy, and the protection of rights.2 The combination and integration of both concepts of risk, according to a patient’s features, his environment, service provision, and quality of networks may better suit the specific institutional and cultural Italian ground for security measures.