Italy: walling up madness

How does Italy handle mentally disordered offenders?

Many individuals who have committed offences and suffer from mental health illness are held under the ordinary prison regime. Others are detained in Residences for the Execution of Security Measures. These persons have different legal statuses, may be placed in several different settings, and receive various levels of care. What is the fate of mentally disordered offenders in Italy?

Prison Insider and the French National Union for Family and Friends of People Suffering Mental Illness and/or Psychological Disability (Unafam) examined the experience of offenders with mental health problems in eight European countries. Here is an overview of the situation in Italy.

Psychiatric hospitals no longer exist in Italy.


ASL (Aziende Sanitarie Locali - Local Health Agencies): public bodies responsible for providing healthcare.

ATSM (Articolazioni per la Tutela della Salute Mentale - Wards for the Protection of Mental Health): special prison units for prisoners with mental disorders.

Casa di cura e di custodia (House of care and detention): facilities for persons subject to a security measure.

OPG (Ospedale Psichiatrico Giudiziario - Judicial Psychiatric Hospital): prisons which, up until the decree of 17 February 2012 (and the closure of the last OPG in 2017), housed people under security measures due to a mental disorder and prisoners suffering from mental illnesses.

Protected Medicine Departments (Reparti di medicina protetta): specific units within general hospitals for prisoners who need medical care.

REMS (Residenze per l’Esecuzione delle Misure di Sicurezza - Residences for the execution of security measures): prisons that house persons under security measures due to a mental disorder (formerly housed in an OPG or casa di cura e di custodia).

Security measures (Misure di sicurezza): measures applicable to any person who has committed an offence, whether they are found responsible, partially responsible, or not responsible. Some measures are custodial, such as hospitalisation in REMS.

SerT (Servizi per le Tossicodipendenze - Services for drug addicts): teams that provide treatment for people addicted to drugs.

SPDC (Servizi Psichiatrici di Diagnosi e Cura - Psychiatric Services for Diagnosis and Treatment): specific units within general hospitals that admit people in psychological crisis.

Supervisory Judge/Tribunal (Magistrato/tribunale di sorveglianza): court with jurisdiction over implementing sentences and measures.

Therapeutic Rehabilitation Communities (Comunità): care facilities in different regions. They operate similarly to REMS.

TSO (Trattamenti Sanitari Obbligatori - Compulsory Care Orders): involuntary treatment order applicable to persons, whether or not they are in prison, who have a mental disorder. The treatment may lead to hospitalisation.