A house divided: deinstitutionalization, medicare and the Canadian Mental Health Association in Saskatchewan, 1944-1964.

Defined as a set of distinct processes that included the declining use of large psychiatric institutions and the increasing use of outpatient services and general hospitals, deinstitutionalization occurred earlier in Saskatchewan than other provinces in Canada. It was led by a CCF government dedicated to major change across a number of sectors including mental health, assisted by one of the most influential and well-organized social movement organizations of the 1950s, the Saskatchewan Division of the Canadian Mental Health Association (SCMHA). However, by the late 1950s and early 1960s, the SCMHA opposed the CCF government's policy priority on medicare which it felt came at the expense of mental health care, in particular the implementation of a regional psychiatric hospital system called the Saskatchewan Plan. As a consequence, the SCMHA, once such a powerful ally of the CCF government in health reform, formed a strategic and temporary coalition with the anti-medicare forces in the province. Given the fact that a number of medical staff within the government's department of public health were prominent members of the SCMHA, the CCF government found that it occupied an increasingly divided house at the very time it was struggling to introduce medicare in the midst of civil unrest and a doctors' strike.

The role of UNASAM - National Union of Associations for Mental Health in Italy.

This paper, after an introduction on the origin, development and principal aims of the National Union of Associations for Mental Health (UNASAM), briefly describes what happened in the last 30 years in the field of mental health in Italy. This period covers roughly the lifespan of the Italian Law 180, from the beginnings, the closure of psychiatric hospitals, to the difficulties of present days. The second part of the paper is a summary of a study commissioned to UNASAM by Istituto Superiore di Sanità and conducted in collaboration with the Istituto di Ricerche Farmacologiche "Mario Negri" of Milan. This research was aimed at evaluating the quality of mental health services in four Italian Regions. Members of patients' families participated with enthusiasm, filling up a questionnaire and engaging in fieldwork, which required more than 3000 working hours and produced significant and useful results.