R-fact: An USA model program for community care of the dangerously insane. Is it possible its implementation in Italy?

The goal of this paper is to describe and discuss the main issues regarding the treatment of the dangerously insane in Italy, in light of the new legislation closing forensic mental hospitals in Italy and the ongoing Legislative reform to deliver security measures concerning the dangerosly insane and the layer group of justice involved adults with severe mental illness. In discussing the above, the present paper discusses, for comparative purposes and possible future implementation in our criminal justice and mental health systems, innovative programs for the community care and safe managment of justice-involved adults with severe mental illness. These programs were developed in the USA at the University of Rochester Medical Center; they are the Rochester Forensic Assertive Community Treatment (R-FACT) and the Safety and Violence Education (SAVE). R-FACT is a new approach for preventing recidivism among justice-involved adults who have multiple recidivism risk factors and have difficulty accessing ordinary community based psychiatric services (office-based treatment) but can be reached at their homes, in shelters, on the streets or elsewhere. The program provides the target population with both continuity of care and promotes the development of collaborative partnerships between mental health and criminal justice agencies. These collaborations encourage patient treatment adherence through use of legal leverage. The SAVE curriculum, on the other hand, is specifically designated to provide effective violence prevention strategies for mental health and criminal justice staff serving adults with serious mental illness in the community. The SAVE program promotes safe practice through identification of the warning signs of impending violence, and provides proven methods for minimizing risk when approaching and engaging high risk individuals in the community.