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  • The Mentally Ill in Italy
    The Virginia Tech tragedy gave everyone – even Italians – a chance to reflect on how to help those who are sick
    Our Paesani

    by Francesca Di Meglio

    APRIL 22, 2007 - The world spent the last week tuned into and horrified by the tragedy at Virginia Tech, where an undergraduate student killed 32 people and then himself in the worst mass shooting in U.S. history. Reports quickly surfaced that the shooter, Seung Hui Cho, had been a troubled individual for some time. A medical institution in Virginia reported in 2005 that he was mentally ill and posed an imminent threat to himself and others. Mental illness - once a taboo subject - became the focus of major media outlets, universities, and the public. While their focus was on the United States, I decided to investigate what Italy is doing for its mentally ill.

    I started thinking about Nicola u' pazz' or Nick the crazy man, who lived in Ischia, the small island off the coast of Napoli that is the home of my ancestors. By the time I knew Nicola, he had a long white beard and wore torn and tattered clothes and a pair of ripped black leather boots even in summer. He hiked the mountains with no particular destination. Occasionally, I'd see him in the piazza. As a child, my father was terrified of Nicola because he often talked to himself right in the middle of the street. One time when we were hiking, Nicola saw us, waved, and said hello almost as if he was a little boy. He smiled. I was a little less frightened. When I mentioned this to my mother's father, Rocco, he told me that Nicola was actually a distant cousin on my mother's side, who had lost his mind years ago. The pazzo was one of us.

    Indeed, there's a little bit of crazy in everybody. The question is how do you detect it? How do you prevent it from letting you get out of control? Who's responsible for your behavior when you become incapable? For most Italians, especially in the south, family takes you in and your mental troubles become their problem. But the mass shooting in Virginia has people around the world asking, “What is the right thing to do?”

    Italy's reaction at first was one of judgment. "Gun violence is becoming a common phenomenon in the United States, one that is no longer surprising," according to Il Corriere della Sera. But Italy - and other developed countries - has its own problems. According to the World Health Organization, Italy only developed a national mental health policy in 1994. In 2005, there were more than 1,552 residential and 612 day care facilities for the mentally ill. More than 13,000 vocational organizations in the social sector that involved more than 260,000 participants existed. But the regional distribution of these facilities was completely uneven with only 20 percent located in the south, which is known to be poorer and in more need of better health care.

    Finding national statistics about Italy is still a bit difficult because the government only launched a national mental health reporting system in 2006. The good news in Italy, however, is that doctors are overcoming bureaucracy and making inroads. Over the last 30 years, mental health professionals in Italy have turned the system from one of asylum, where the mentally ill were locked away and abandoned by society, to one of treatment.

    In January 2007, Newsweek and reported that some Italian doctors have successfully treated mentally ill patients with depression, multiple-personality disorders, bipolar disorder, and schizophrenia by using a treatment plan that included the strategic game of soccer, the nation's favorite pastime. Volfango De Biasi and Francesco Trento followed a team of patients playing soccer as part of their treatment in the documentary Matti per il Calcio. What doctors are discovering is that team sport helps with socialization, concentration, and confidence when paired with other treatments.

    These advances give Italians - and me - hope for others like Nicola. And the awareness might even help prevent massacres like the one at Virginia Tech from ever happening again. We can only hope and pray - and make our mental health systems work better.

    For more stories by Di Meglio, visit


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