Heart Forward Conversations from the Heart
The American mental health system is broken beyond repair. Rather than trying to tweak a system which fails everyone, it is time to commit to a bold vision for a better way forward. This podcast explores the American system against the plumb line of an international best practice, recognized by the World Health Organization (WHO), in Trieste, Italy. The 40-year old Trieste model demonstrates how a community-based treatment system upholds the human rights of the people served. The Trieste story is anti-institutional and models the therapeutic value of social connection. Topics will address contemporary challenges in the American failed mental health system as contrasted with the Italian approach toward accoglienza – or radical hospitality – as the underpinning of their remarkable culture of caring for people. Interviews will touch upon how the guiding principles of the Italian system – social recovery, whole person care, system accountability, and the human right to a purposeful life – are non-negotiable aspects if we are to have any hope of forging a new way forward in our American mental health system. This podcast is curated and hosted by Kerry Morrison, founder and project director of Heart Forward LA (https://www.heartforwardla.org/). Heart Forward is collaborating with Aaron Stern at Verdugo Sound as the technical partner in producing this podcast (https://www.verdugosound.com). Kerry Morrison is also the author of the blog www.accoglienza.us.
Heart Forward Conversations from the Heart
Building trust takes time: A conversation with Claudia Battiston, Psychiatric Rehabilitation Technician in Trieste
In this episode, we speak with Claudia Battison, a Psychiatric Rehabilitation Technician (PRT) in the mental health system in Trieste Italy. I am joined in this interview by Dr. Joy Agner, Assistant Professor at the USC Chan School of Occupational Therapy and Occupational Science at USC.
Heart Forward has become particularly interested in the potential role that occupational therapists -- if empowered to practice their profession to its full potential -- could play in mental health support settings in the U.S. Unfortunately, the way that OT services are primarily funded (through short-term, medically oriented reimbursement systems) constrain their ability to come alongside people in their recovery journey over the long term.
This topic was already approached in a Season Four podcast with Dr. Deborah Pitts from USC’s Chan School.
In this conversation, we learn about the ways in which the PRT engages with the system users. Three stark differences emerge:
- Time. There are no deadlines. They are afforded the time necessary to get to know the user and tease out the life plans/goals (also referred to as a personal rehabilitation project) that are meaningful to the user.
- Friendship. The relationship is described more like a friendship than what might be more typical in an American context. This equates with the ethos of coming alongside people in horizontal relationships that eschew the power dynamics associated with “professional” more verticalized relationships.
- Team. The PRT is part of a broader team – an équipe of other “operators” (their word for staff) – in the Community Mental Health Center. The other team members can help to weigh in on how to support the system user; the PRT is not left to his or her own devices.
And, or course, all of this is grounded in the belief that a mental health system must support a person in all three pillars of one’s life: casa, lavoro e socializazzione, or housing, work/purpose and community. The PRT must pay attention to each of these pillars to provide support for recovery.
As we have researched this further, it appears that this role if fairly unique to Italy and was created to augment the psycho-social support that is an underpinning to the Italian model. As described in one of the articles linked below, “Psychiatric rehabilitation technicians are trained to perform multidisciplinary rehabilitation and education interventions for people and their carers.”
Here are two articles about the role of the Psychiatric Research Technician.