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Urban Suffering Studies Center

 

 

Actions for the mental health of Italian and foreign seriously marginalized people within Casa della Carità's strategy

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Silvia Landra

 

Practice while waiting for theory
Silvia Landra

Casa della Carità in Milan is a vital environment providing accommodation for 120 people as well as day rooms, which does not intend to create similar places but possibly to enhance similar practices, new and diversified projects, opportunities to ask oneself how psychiatry can meet the needs of an urban context today.
Casa della Carità was created 5 years ago on the basis of an agreement between Cardinal Maria Martini, who set aside the inheritance of a Milan benefactor, Mr Angelo Abriani, for the initial stage of the project, and the Mayor of Milan who provided a suitable building in the area of Crescenzago.
The Bishop and the Mayor, the ecclesiastical facet and the civic facet of the city, took up the challenge of treatment as a right of citizenship. Don Virginio Colmegna, who was bringing with him the results of his years long theoretical and practical work on mental health in the Diocese of Milan, became its president.

OBJECTIVES

Access to treatment


- To concentrate on the mental health of those people who have broken off contacts with treatment services (the "lost sight ones") or those who, although ailing, do not feel like turning to treatment services (the "never seen ones").
- To guarantee treatment and citizenship to everybody, also to those Italian people who lost their health insurance because street life has deprived them of personal data, or to the frail foreigners who have not been able to legalize their status.
- To offer ways to make people aware of their illness and motivate them to treatment, while trying to make a therapeutic-reabilitative process possible for those "who do not turn up".

Deinstitutionalization

To act in seriously marginalized situations both in the street and at home, with the aim of carrying out two paradoxes of the metropolitan context: a street which can become a total institution that it is difficult to leave and a home which can become a "no-place " where it is difficult to enter.

Self-promotion

To promote self-determination and assumption of responsibilities in people who describe themselves as losers, who have lost their possessions and their bonds, who have relegated themselves in the "invisible city", the city of extemporaneousness, of begging and tricks.

Prevention

To be near people and groups that live in degraded districts and to enhance inclusion strategies paying special attention to those persons who are not ill but risk developing crisis.

STRATEGIES

The logic of concentric circles

We deal with people who tend to uproot themselves and never to stop in a place. For instance, following a scheme well-known to residential services, the fees stop being paid after 3 days' absence. You have to start it all again. Enthusiasm decreases and the time necessary to find proper answers grows longer especially in the case of homeless people. This can be demotivating for the team following the case. Whereas it seems worthwhile to set up places that allow discontinuous accommodation, as experimentation shows.
The picture of concentric circles can help: the person and his/her needs is at the centre and he/she can move from one circle to the next, that is to say from a more sheltered position to a more autonomous one, moving back and forward until the next step has been consolidated thanks to greater self-assurance. It is fundamental that the concentric circles are part of the same system of thought, that involve more services and more spaces. There should be no leaps in the dark, but rather well-known movements commented on with the person. Besides the clinical answers coming from the psychiatric panorama of our region which cannot be replaced, we promote different levels of protection, accommodation, reinstatement. The logic of concentric circles refers also to the professional who knows how to combine action based both on external intervention making needs and answers meet, and on internal intervention making wishes and needs meet.

Reversing the axis user-service

We question the idea that the direction to be followed during treatment is the one that takes the person who is in need to the service that supplies help. We want to imagine mobile places where to be treated, places nearer to the persons, so that the ambulance may not be the only available service and the hospital emergency ward may not be the only place known to some people. We try to take professional skills onto the road, at times when city services are not available or to the very house, devoting extended time to observing, meeting, making people aware of the fact that they need help.

Assisting and accompanying

Working on the street teaches you how to move as well as to walk long distances. Walking along the streets of a big city may be disturbing, distracting and painful for the frailest ones. We have watched emotions loosen up and individual resources come out on activating the practice of accompanying people. We do not only mean the social worker who takes the person somewhere, but also the psychologist who gets to know the homeless person better while watching the routes he/she follows, or the legal advisor standing in a queue with a foreigner in the police office, or the psychiatrist accompanying somebody to a visit at CPS, or the educator accompanying a person and living the city together with him/her.


Bread an culture

Promoting rehabilitation in a city and not in a village means to take into consideration the fact that the territory in a metropolis looks different, it is lived not through space contiguity (the familiar shop, the nearest cinema, district life ....) but through symbolic and meaningful places.
In order to get out of the invisible city people need to be able to enter Milan and its fine streets, see its artworks and entertainment venues. The cultural and artistic activities organized outside the "Casa" and promoted inside it try to reduce citizens' stigma and shorten the distance separating the strong from the frail.

PRATICE AND FIGURES

Accommodation


• Abramo Floor: 50 beds for men (late afternoon and night)
• Sara Floor: 40 beds for women (late afternoon and night)
• Staying Community: 10 beds in a flat (day and night)
• Nest House: 4 miniflats for mothers with children (day and night)
• Small House: a prefabricated building for 10 families (day and night)

Street action

• Diogenes Project: multidisciplinary team for mental health

Domiciliary actions

• Let's Try Again Project (about 70 people in Molise-Calvairate district)
• Flat Network Project (10 people)

Preventive actions

(contexts in which mental health counselling or mental health treatments can occur according to circumstances even without accommodation in Casa della Carità network)• ROM campsites (800 people attended)
• Shower services to external people (200 persons per week)
• Listening Centre (20 newcomers per week asking for accommodation)

 

 

By the same authors:  Subjects seeking refuge and in subsidiary protection who have been tortured: paths for care and processes for human development 


 
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Center for urban suffering

The study centre wishes to study the phenomenon of urban suffering, in other words the suffering that is specific to the great metropolises. Urban Suffering is a category that describes the meeting of individual suffering with the social fabric that they inhabit. The description, the understanding and the transformation of the psychological and social dynamics that develop from the meeting of ...

Who we are

The Urban Suffering Studies Center - SOUQ - arises from Milan, a place of complexity and economic and social contradictions belonged to global world.Tightly linked to Casa della Carità Foundation, which provides assistance and care to unserved populations in Milan (such as immigrants legal and illegal, homeless, vulnerable minorities), the Urban Suffering Studies Center puts attention on ...

Staff

Centro studi Souq Management commitee: Laura Arduini, Virginio Colmegna (presidente), Silvia Landra, Simona Sambati, Benedetto Saraceno ; Scientific commitee: Mario Agostinelli, Angelo Barbato, Maurizio Bonati, Adolfo Ceretti, Giacomo Costa, Ota de Leonardis,  Giulio Ernesti, Sergio Escobar, Luca Formenton, Francesco Maisto, Ambrogio Manenti, Claudia Mazzucato, Daniela ...
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ISSN 2282-5754 Souquaderni [online] © by SOUQ - Centro Studi sulla Sofferenza Urbana - CF: 97316770151
Last update: 26/11/2020
 

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