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The Trieste model: Obstacles to replication in San Francisco 

The Trieste model: Obstacles to replication in San Francisco
The Trieste model: Obstacles to replication in San Francisco

Robert Okin

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date: 11 April 2021

This chapter describes a collaboration between academics from Berkeley and leaders of the Trieste mental health system and of San Francisco General Hospital, to determine the feasibility of replicating the Trieste model of mental healthcare in San Francisco. The participants ultimately concluded that Basaglia has had no influence on the mental health system in the United States, and determined that the obstacles to replication of the Trieste model were, in whole or in part, insuperable at this time. Among these obstacles are the demographics of the population in San Francisco (e.g. large numbers of poor, disabled people competing for the same small resource base), the pervasiveness of substance abuse among the mentally ill population, the extent of homelessness and criminalization of the mentally ill, the dearth of affordable housing, the predominant use of the medical model, and the fee-for-service financing system which supports this model.

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