The European Court of Human Rights ruled on Thursday that Italy violated the rights of a man who was held in psychiatric detention for nearly a decade, in violation of the country’s legislative shift toward deinstitutionalization.
The case was brought by Fabio Cramesteter, who was convicted in 2003 on weapons possession and theft charges. The following year he appealed and was acquitted by reason of insanity. As was customary at the time in Italy, he was then transferred to a forensic psychiatric hospital (Ospedali Psichiatrici Giudiziari; OPG) — essentially a mental institution for people who successfully pled insanity, as well as people with substance abuse disorders. Initially, Cramesteter was sentenced to two years in the facility, but his sentence was repeatedly extended, and ultimately he remained in psychiatric detention until 2016.
According to a 2017 article in the International Journal of Law and Psychiatry, Italy’s OPGs emerged from the belief, espoused by 19th century criminologist Enrico Ferri, that some people were born criminals, could not be rehabilitated, and should thus be isolated from society. Throughout the first half of the 20th century, these facilities were more carceral than clinical in nature. By the 1960s, many countries began to question the wisdom of permanently isolating people with mental illnesses, giving rise to the deinstitutionalization movement. In Italy, Franco Basaglia, a psychiatrist who was imprisoned for his anti-fascist views in 1944, spearheaded a successful deinstitutionalization campaign that brought about the closures of all general-population asylums in favor of community care. The only asylums that remained after 1978 were the OPGs, which were excluded from the reforms because they were operated by the country’s justice ministry rather than health officials. By the early 2000s, there was a pronounced gap between Italy’s thriving community mental healthcare system and its OPGs, which after years of budgetary constraints, offered little to nothing in the way of mental healthcare.
Following accusations of inhuman and degrading treatment by the Council of Europe, Italy moved in 2014 to order the closure of all OPGs by the end of March 2015. The same legislative reforms made it illegal to hold anyone who was acquitted by reason of insanity in psychiatric detention for longer than they would have faced in jail if convicted.
By this logic, Cramesteter should have been eligible for release in February or March 2015. He was not released into community care until May 2016. The following year, Cramestater filed suit in Italy for wrongful detention, but his claim was rejected by the courts, which found the psychiatric sentencing limitation lacked retroactive applicability.
The ECHR found that Italy violated Cramesteter’s rights to liberty and security, as well as his right compensation for unlawful detention as enshrined in the European Convention on Human Rights (Article 5, sections 1, 3, and 5). Italy was ordered to pay Cramesteter 8,000 euros in damages.
