The role of REMS of Caltagirone in the path of the offender psychiatric patient: a retrospective analysis

Giulia Saitta¹, Serena M. Sturiale¹, Salvatore Aprile², Fabiola Chiarenza², Carmelo Florio³, Eugenio Aguglia¹

¹ Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Catania, Italy; ² REMS Caltagirone, A.S.P.3 CT, Italy; ³ Department of Mental Health, Catania, Italy

Objectives

Our study focused on the follow-up of patients admitted in Caltagirone’s REMS once the security measure ends, in order to detect critical issues and strengths in the transition from OPGs to REMS in Sicily.

Methods

An analysis of the given data regarding the Caltagirone REMS/Catania DSM (Mental Health Department) system has been carried out. The time-frame covers two intervals: one that goes from the opening on April 2015 to October 31, 2020, regarding male patients who were discharged, and another that goes from the opening on March 2018 to October 31, 2020, concerning the same situation for female patients.

Results

Collected data on the pathway toward recovery and independence of Caltagirone’s REMS population confirm the need to scientifically monitor the local psychiatric services and the REMS’ system in order to improve the Italian forensic psychiatric health service management. However, the therapeutic model adopted by Caltagirone’s REMS, seems quite effective.We found encouraging results about duration of residency in REMS: less than one year for the female sample and less than two years for the male one. Many of ex-guests still live in CTA: this aspect reflects the problem of the “isolated asylum” of forensic psychiatric patients and their difficult full reintegration into the Italian society due to lack of ambulatory services once REMS security measure ends. Finally, we found that a few former male patients are waiting for a new admission into REMS for other crimes: further studies are required to define which diagnostic, social and environmental factors could influence therapeutic and rehabilitative REMS’ programs outcome.

Conclusions

The multidisciplinary model adopted by Caltagirone’s REMS is successful, although additional improvements are needed in order to enhance psychiatric ambulatory services and to monitor information about forensic psychiatric patients once the security measure ends.

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