From Bachelor Thesis to Scholarly Article: Caterina Ronchetti and the Basaglia Law

A STUDENT IN THE BSC IN INTERNATIONAL ECONOMICS AND FINANCE, CATERINA FOUND A POSITIVE CORRELATION BETWEEN THE CLOSURE OF ASYLUMS AND SUICIDE RATES OF THE MENTALLY ILL IN ITALY. THIS WEEK, THE EUROPEAN JOURNAL OF PUBLIC HEALTH PUBLISHED A REVISED VERSION OF THE STUDY

More than forty years ago, Italy implemented one of the most radical, but contested mental health reforms, the Law 180/1978 or the so-called Basaglia Law. The core idea of the Basaglia Law was to close psychiatric hospitals (asylums) and shift care to the new Community Mental Health Centers. So far, only a handful of studies have investigated its impact, mainly because of the lack of data. More recently, Caterina Ronchetti, in her BSc in International Economics and Finance thesis, found that the implementation of the law was associated with a significant increase in the suicide-rate among those mentally-ill.
 
Caterina, a 23-year student from Bologna, proposed a bachelor thesis on the Basaglia Law to Professor David Stuckler while enrolled in the Health and Society course. «I had in mind a theoretical thesis, but Professor Stuckler convinced me to work on a research thesis, with a strong empirical background, focusing on the effects on suicides».
 
Confirming Thomas Edison’s quote that genius is one percent inspiration and ninety-nine percent perspiration, what followed was a hard work. Caterina combed historical data archives and found healthcare data for the period 1975-1984 and transferred them from the original Italian sources, cross-checking them with population data available online to ensure their validity. «With the guidance of Professor Stuckler and using statistical software I, then, analyzed the data in order to single out the effects of asylums closure».
 
Commenting on Caterina’s work, Professor Stuckler noted: «It is extremely rare that our undergraduates produce work of such high caliber that it is recognized independently by other international scholars in the field to merit publication in a leading journal. Caterina had an excellent idea, and the tenacity to see it through to completion. Of course, we are extremely proud of her hard work; she has a bright future».
 
In the final months of 2018, the thesis moved towards a peer review article and it became a team work with the collaboration of Dr. Veronica Toffolutti, a Research Fellow at Dondena Research Centre, and Professor Martin McKee, a leading public health expert and currently Professor of European Public Health at the London School of Hygiene and Tropical Medicine. The paper vis-à-vis the thesis, beside using more sophisticated statistical techniques, delves deep into the underlying sociological mechanisms behind the results, explaining that the closures of facilities left those with mental illness with nowhere to go, as the envisioned community care structures failed to be developed as originally plannedand this led to an increase in the number of suicides.
 
As the review process took almost one year, Caterina is now completing her studies at Bocconi’s MSc in Economics and Management of Government and International Organizations and is currently an intern at the Boston Consulting Group. «I do not have a clear idea of my future, yet», she says, «but consulting in healthcare topics could be an option».
 
The article has been published yesterday as: Caterina Ronchetti, Veronica Toffolutti, Martin McKee, David Stuckler, “The quantification of the psychiatric revolution: a quasi-natural experiment of the suicide impact of the Basaglia Law”, in the European Journal of Public Health, 2020, 1-5, DOI: 10.1093/eurpub/ckaa011.

by Fabio Todesco