Italian and American Approaches to Mental Health: A Comparative Study of the Bio-Psycho-Social Model

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Course Information
Terms offered: 
Fall, Spring
Language of instruction: 
Contact Hours: 


Additional student cost: 



The course will analyze the interaction of biological, psychological, and social determinants of the individual’s mental functioning and behavior and different approaches to mental healthcare; emphasis being placed on both the theoretical and practical aspects. The bio-psycho-social-cultural model to diagnosis and care and its theoretical and therapeutic implications will be brought into discussion, taking into account the scientific world’s most current perspective. We will also undertake a close study of the Italian and American approaches, drawing comparisons and highlighting the difference in methods and outlook between them.

The course is divided into different areas, firstly covering notions of clinical Psychology with a comparative analysis of the different psychological and biological models in Europe and in the US, rehabilitation approaches to mental illnesses and also correlation factors between severe mental disorders and criminal offence.

The course will also focus on the changes that have come about in this field in different countries in the last 50 years; they represent the result of a crisis and upheaval in the area of mental health in the western world and the way it was addressed. The resulting reforms (e.g. the introduction of the Basaglia community centers in ’62 in Italy etc.) and the introduction of new drugs marked the beginning of the deinstitutionalization process and the establishment of psycho-social services in each territory with more direct contact with the community. Italy has been one of the countries in the forefront of these changes with a unique formula for its mental health reforms, which have been studied as a field leader.

Analysis will be undertaken of mental health issues and their social implications such as crime, risk, and protective factors in criminal behavior and treatment of offenders within the penitentiary and psychiatric systems. During the course, emphasis will be placed on the practical aspect with the participation of guest speakers, discussion of clinical cases, field studies involving student visits of both private and public institutions, research and/or rehabilitation centers where this model is being represented.

Attendance policy: 

Regular class attendance is mandatory. Students are expected to attend classes each day, including course-related excursions.

IES Abroad Milano allows a maximum of TWO excused absences per semester. Each further absence will automatically result in a penalty of two points off (2/100) on the final grade. SEVEN absences per course (including 2 excused absences) will result in a failing grade for that course. Furthermore, an absence on the date of scheduled tests, presentations or quizzes does not entitle you to recover/reschedule such tests. Failure to attend your midterm and/or final exam will result in an F grade on that paper/exam.

Method of presentation: 
  • Lectures and discussions
  • Field trips
  • Critical analysis of assigned readings
  • Lectures with guest speakers
Required work and form of assessment: 
  • Attendance - 10%
  • Active participation through discussion, reading and writing (including analysis of clinical cases) - 10%
  • Home assignments - 30%
  • Mid-term examination - 20%
  • Final examination - 30%




An introduction to the Italian Healthcare System


Towards the Deinstitutionalization Process: Franco Basaglia and 180 law


An overview of current approaches and challenges in the Mental Health Sector : an international perspective


Introduction to Anormal Psychology: classification and diagnosis. Is it the same world wide?


DSM 5 (USA 2013): a descriptive, nosological approach


PDM (USA 2006) : a psychodynamic approach


Psychopathology: Mood Disorders, Personality Disorders. An overview of current scientific contributions


Theories of Psychoses and Schizophrenia 


The cultural factor in Psychopathology


The current Healthcare Reform in the United States: organizational and economic aspects of the US Healthcare System 


The Affordable Care Act


Elements of the Italian Judicial System


The Notion of Social Dangerousness: a comparative analysis from a psychopathological and Transcultural perspective 


Deinstitutionalization and Crime: is there a correlation?


Crime and PTSD: risk and protective factors


Class discussions and role plays of 5 clinical case studies


Required readings: 


  • Shulamit Ramon and Maria Grazia Giannichedda, Psychiatry in Transition; the British  and Italian experiences  ( 1991)  Pluto Press (selected Chapters)
  • Diagnostic and Statistical Manual of Mental Disorders , DSM 5.  (2013)  American Psychiatric Association (selected Chapters)
  • Psychodynamic  Diagnostic Manual, PDM  (2006) American Psychoanalytic Association (selected Chapters)
  • Bhugra D., Bhui K., Textbook of Cultural Psychiatry (2007) Cambridge University Press (selected Chapters)
  • Romme M., Escher S., et al Living with Voices (2007) PCCS Books (selected Chapters)
  • The Essential Book of Offenders Assessment and Treatment (2004) Edited by C. R. Hollin, John Wiley &Sons Ltd. (selected Chapters)
  • Gunderson J., A BPD Brief An introduction to Borderline Personality Disorder, Diagnosis, Origins, Course and Treatment (2006) (The Borderline Personality Disorder Resource Centre, New York, Presbyterian hospital; (selected Chapters)
  • Scott, C.L.,Quanbeck C.D., and P.J. Resnick Assessment of Dangerousness (2008) (The American Psychiatric Publishing Textbook of Psychiatry; 5th Edition; American Psychiatric Publishing Inc (selected Chapters)


  • M. Spivak “ Socializing Interactions in Psychosocial Rehabilitation Programs” (Italian Journal of      Psychiatry and  Behavioural Sciences 1993)
  • Ascoli M., Tennyson L., et al Race, culture and personality disorder. Group Careif position paper (2011) World Cultural Psychiatric Research Review
  • Mattar S., Drozdek B., et al Introduction to Special issue: Culture and Trauma (2010) Traumatology
  • Hinton D., Lewis-Fernandez R., The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5 (2010) Depression and Anxiety
  • Patel V., Maj M., et al Reducing the treatment gap for mental disorders : a WPA survey (2010) World Psychiatry
  • Sartorius N., Gaebel W., et al WPA guidance on how to combat stigmatization of psychiatry and psychiatrists (2010) World Psychiatry
  • Mc Daid D., Thornicroft G., Policy Brief: Mental Health II, Balancing Institutional and community-based care (2005) European Observatory on Health Systems and Policies
  • De Girolamo G., Bassi M., et al The current state of mental health care in Italy: problems, perspectives , and lessons to learn  (2007) Eur Arch Psychiatry Clin Neuroscience
  • Banti S., Borri V., et al Perinatal mood and anxiety disorders, Clinical assessment and management. A review of current literature (2009) Giornale Italiano di Psicopatologia
  •  Shepherd-Hughes, A.Lovell M.,Breaking the Circuit of Social Control: Lessons in Public Psychiatry from Italy and Franco Basaglia (1986) Soc. Sci. Med.
  • Caracci G.,General Concepts of the Relationship between Urban Areas and Mental Health (2008) Curr. Opin. Psychiatry
  • Bhui K., et al, Cultural Competence in Mental health care: a review of model evaluation (2007) BMC Health Service Research
  • Birmingham L., et al. Mental Illness at Reception into Prison  (2000) Journal Criminal Behaviour and Mental Health
  • Vuolo M.  Kruttschnitt C., Prisoners’ Adjustment, Correctional Officers, and Context: the Foreground and Background of Punishment in Late Modernity  (2007) Law and Society Review  ProQuest Psychology Journals
  • Dhami  M.K.,et al. Adaptation to Imprisonment: Indigenous or Imported? (2007) Journal Criminal Justice and Behaviour;
  • Lovell A.M., Sheperd-Hughes Deinstitutionalization and Psychiatric Expertise: Reflections on Dangerousness, Deviancy and Madness ,(1986) International Journal of Law and Psychiatry
  • Rochefort  D.A., Mental Health Reform and Inclusion of the Mentally Ill: Dilemmas of US Policy-making  (1996) International Journal of Law and Psychiatry