1. Day Centres as Meeting Places and Turning Points in the Rehabilitation Pathway
Paolo Francesco Peloso and Lucia Valentini
Dept of Mental Health and Substance Abuse, Genoa, Italy

2. Mental Health Centre (MHC) is defined as a service aiming to:
Provide outpatient psychiatric care to general population
Offer long term outpatient service to people with severe mental health problems
Provide recreation and rehabilitation activities assisted by health workers
Offer, when needed, sheltered accomodation
Most Italian Community Mental Health Centres, however, only fulfill the two first objectives.
Article’s question: How to meet the third need?

3. Generally separated from the MHCs
Day Care
“[...] a semi residential structure with therapeutic and rehabilitation functions aimed to prevent and limit hospital admissions. [...] Services include a range of occupational programs focused on the acquisition of skills tht may be employed in a work setting.”
Generally separated from the MHCs
Number of patients range depending on the size of the facility and type of activity undertaken
Limited time, concluded with full introduction within society and work
Usually open 5 days a week

4. Staying-Oriented Model
Work toward preventing psychiatric hospital admissions and reducing symptoms by taking advantage of the residual abilities
Welcome and affective, possibility of finding emotional residence. – “Here I can be myself and be accepted”
Provide opportunities for resocialization, rescuing patients from isolation. The social contact itself performs the function of therapy
Problem: Some people don’t fully heal, reaching a state of chronicity, which makes discharge extremely difficult

5. Activity-Oriented Model
“Shelter Workshop” – foster the development of work skills in order to make disabled subjects capable of performing activities
Subjects feel useful and productive
Risk of presenting illusory expectations for possible long-term adaptation in a real workplace
Persons who cannot engage in activities or cannot function at sufficient level may eventually be excluded

6. Model Oriented on Going Beyond
Personalised rehabilitation projects
Transfer the focus from the health worker’s interests to the patient’s needs
Client’s decision making ability is taken into account
Focus on patient’s discharge

7. Day Centre x Mental Health Hospital
Allows people to spend their lives in non-institutional environments
Limit person’s dependency on psychiatric institution and preserve their autonomy
Improvement of a person’s behaviour within their own environment
Problem: “New Chronicity”
Problem: Lack of Public Health support
Problem: Challenging clients
Conclusion