Conference Program

This work investigates how neoliberal rationality is reshaping institutional mandates and clinical practices within Italy's public territorial mental health services, drawing on an empirical case study of the Emilia-Romagna region. Italy was the first country to legislate the closure of asylums (Law 180/1978), establishing a community-based psychiatric model centred on territorial Mental Health Centres. Emilia-Romagna played a pioneering role in this process and remains among the best-resourced regions nationally, making it a critical case: if structural tensions between care and managerial logic manifest even in a context of relative excellence, the phenomenon acquires systemic rather than contingent significance.

The theoretical framework combines Foucauldian genealogy with materialist analysis. From Foucault's lectures on biopolitics and governmentality, the study draws the concept of neoliberalism as a rationality that governs through freedom, structuring the field of possible action rather than imposing direct constraints. This lens is integrated with Chapman's neurodivergent Marxism, which grounds the genealogy of normality in material structures, Castel's analysis of risk management and the post-asylum reconfiguration of the psychiatric apparatus, Rose's account of governing through community and the production of autonomous, responsibilized subjects, and the contributions of Brown, Dardot and Laval on neoliberal subjectivation.

Methodologically, the research employs a qualitative exploratory design based on a single holistic case study. Data were gathered through four semi-structured in-depth interviews with strategically sampled key informants positioned at different levels of the apparatus — governance, clinical practice, and civil society — and through the analysis of regional institutional documents treated as artefacts of managerial rationality. The analysis follows Braun and Clarke's thematic analysis within an abductive logic.

The findings reveal that neoliberal rationality does not operate through frontal opposition to the logic of care, but through subsumption. The managerial grammar of performance indicators renders relational care invisible: what resists quantification tends to disappear from institutional visibility. Structural resource scarcity, the decline of territorial outreach, and the transformation of Mental Health Centres into predominantly outpatient services are experienced not as externally imposed constraints, but as internalized conditions — precisely the mode of governing through freedom that Foucault theorized. Furthermore, the institutional adoption of the recovery paradigm, while retaining emancipatory potential when grounded in material conditions and egalitarian relationships, simultaneously functions as a vehicle for the subsumption of neoliberal logic, shifting the burden of care from public services to families and the third sector and risking the responsibilization of individuals for structural failures. Finally, the analysis identifies a paradox of resistance: operators' capacity to deliver quality care despite structural constraints may inadvertently stabilize the very apparatus they contest, insofar as the system need not change while good clinical work continues to mask systemic inadequacies.