Three sketches for a portrait

Abstract

In the economy of the Department of Mental Health, the Mental Health Centre is the main place where citizens and the public health service can meet and interact concerning all those situations and needs related  – in the public’s interpretation of the term –  to the sphere of mental health. The hospital Psychiatric Service for Diagnosis and Care is the other possible access point to the Department, but only for conditions that are urgent in that they constitute a danger to oneself and others.
The Mental Health Centre, which should be a facility always open to the public, receives a varied and substantial range of demands, consistent with its initial underlying mission and with the transformations and expansions it has undergone over the years.
Today, the managers and administrators believe by and large that the so-called “core business” of the MHC and of the entire Department is made up of the assistance needs of the users that, from the “ex iuvantibus” viewpoint, used to be sent to the Psychiatric Hospital. But it is recognized that alongside this type of client, there are many other kinds of needs and demands. For instance the whole large area of so-called “common emotional disorders” or “common mental disorders”. On this point, a recent extensive study reports that 7,3 % of the general population say that during the past year they have suffered at least once from something that falls into this category. Then there are a series of situations that cannot be considered common, but that do not display levels of dangerousness or obvious deviance from the norm such to be considered “core business”, and that anyway are associated with great difficulties and acute suffering for those presenting them (think for example of what is currently said about the progressive increase in the occurrence of borderline personality disorder). This complexity in the demand directed at the MHC inevitably reminds us of the need to diversify the responses that the service offers and the interventions it implements. 
And what about psychological competence? How is the psychological competence present in Mental Health Centres – to varying degrees depending on the different regions of Italy –  implemented in this panorama and what could it offer that is new?
We will try at this point to outline a possible, partial operative plan for psychology in the MHC, through the presentation of three short reports, or rather sketches, of three clinical situations. Each will bring up points that prompt reflection.