This house and workshop for young adults (ages 18–35) with mental illness stands as a remarkable example of humane and economical response to the crisis that followed Italy's mental health reform law and the closure of psychiatric hospitals. Its story tells us why.
The foundation is the cooperative "Insieme si può" (Together We Can), with 630 members in Conegliano and surrounding towns in the Treviso province. "We've existed for fourteen years now," explains president Rina Biz, "and we practice solidarity among ourselves before anyone outside guarantees us work." The account that follows draws on conversations with Biz, psychologist and center director Patrizia Furlan, music therapist Egle Bottega, and a visit to the site itself.
We knew that by 1996 the last psychiatric hospitals would have to close. In early 1995, Eugenio Rovignani, the bishop of Vittorio Veneto, reached out to us. He was hearing from desperate families every day—families with mentally ill relatives at home they couldn't manage. The crisis would only grow worse once the hospitals shut down entirely. "You are a Christian-inspired organization," he said—the cooperative had roots in Catholic Action—"and you have assistance to the mentally ill among your mission. Start something." He called the parish of S. Lucia di Piave, which owned this building they'd built to house elderly people, and proposed they rent it to us. That's how we started this therapeutic recovery program. Today we care for 25 people with mental illness, supported by 15 staff members and 4 civil service volunteers.
Work is essential for "treating" and, ideally, reintegrating young people with mental illness into society. So we rented a 600-square-meter warehouse, renovated it, and equipped it for different kinds of work. That's how IDEA LAVORO—the occupational center, the second pillar of this initiative—came to be.
The work happens at two levels: educational, to acclimate residents to a work environment, and productive, though protected—for instance, with reduced hours. Residents are here from 9 a.m. to noon and 2 p.m. to 4 p.m. We contract with local businesses, and we're always trying to build those relationships. Most of the work is simple assembly. For now it's done mainly by cooperative members (who work regular hours—delivery deadlines to companies have to be met), but already some of our residents are starting to transition from educational to productive work.
Soon we'll set up a real wage system with proper payroll records for them.
As residents recover from their illness and regain "segments of normalcy," they move into real, unsimulated work.
We opened the occupational center in July 1995. Educational work follows a personalized plan developed by the psychiatrist treating each person and our own psychologist.
Today in the center, some young people are simply present to get used to an environment where people live and work together, while others are already doing productive work.
The facilities are well-maintained. Discreetly placed cameras allow us to monitor residents carefully. When I walked through the kitchen, they were preparing risotto with gorgonzola for lunch—that explained the unmistakable smell!
Residents are either full-time boarders or day clients (morning to evening, then home). They work, eat together, receive therapy, music therapy, movement therapy, and more. Once they've achieved stable equilibrium and can earn something, they should move into their own apartments—alone or in groups of two or three—with some centralized services and minimal external supervision. We're working with other organizations to find these living spaces. In short, the steps toward recovery should look like this: residential community, workshop, work subsidy, supervised outside work, independent work. How many steps each person will take depends on their individual situation. Right now we have one resident on the special placement employment list, working at a nearby factory, and two with work subsidies—one will work in a library, the other in municipal grounds maintenance.
For this venture, the cooperative invested roughly 500 million lire to equip the spaces. Members fund the cooperative, motivated partly by "gratitude for being healthy and economically secure."
The bishop contributed about fifty million lire (from the Church's tax donation fund). The local health authority, AUSL 12, pays the center a daily rate for full-time residents (around 170,000 lire per day) and a reduced rate for day clients: one-third is covered by health services, one-third by social services, and one-third by the family or the resident's home municipality.
We also have patients from other areas (currently two), whose local health authorities cover the cost.
Work is essential for "treating" and, ideally, reintegrating young people with mental illness into society.
The real financial pressure is the portion borne by families—roughly 1,800,000 lire.
Most of our residents come from very difficult family situations, so we discourage weekend visits home; we believe their home environment was often a source of their distress. We maintain contact with families through two monthly meetings between staff and relatives (most do attend).
Without this program, most of these young people would end up cycling through involuntary psychiatric hospitalization at a cost of 500,000 to 600,000 lire per day, spending a month or six weeks each time in the hospital. Since we opened, only one resident has needed such hospitalization. That makes this initiative economically sensible as well.
How does the local community view having a mental health center here?
A decade ago, when people first heard about opening a program for the mentally ill in town, they didn't want it. Then the parish priest, bishop, and mayor helped shift community attitudes. We've created many occasions for contact. Residents attend the parish church; the local scout group comes to run activities here. Residents go out on their own to buy newspapers, bread, and vegetables. They stop at the café during breaks. They use municipal services. By and large they're welcomed well—and honestly, they don't cause any real trouble.
The public agencies recognize—something not always obvious—that the cooperative does quality work.
— Sergio Sciascia, 1997