The intelligence of the heart

by Massimiliano Fanni Canelles

The international scientific community has recently decided to replace the term "mental retardation" with "intellectual disabilities". The intellectual disabilities include restrictions in the functioning emotional, social and education for low adaptability (adaptive functioning). The CNE results in a lack of personal autonomy. The fact of not knowing how to deal with the difficulty becomes the main distinguishing feature. Adaptive functioning is directly influenced by IQ, but other factors are significant, as the different personalities and mental disorders.

The causes of intellectual disability may be genetic, hereditary syndromes with the expression of gestation and for abuse of alcohol and drugs by the mother. Additional predisposing factors may be trauma at birth and premature birth itself, or intracranial hemorrhage or cerebral ischemia and infectious agents involving encephalitis or meningitis.

But these are also added social elements: it was observed that sensory and affective deficiency can induce alterations of psychic development. The intellectual disability are frequently associated with psychiatric illness and, in this case, the incidence is three to four times higher than the general population. The psychiatric disease may therefore overlap with mental retardation. Indeed, mental retardation itself is one of the most important factors for psychiatric vulnerability. Mental disorders are the most common psychosis, depression, conduct disorder, anxiety disorders, affective disorders, attention deficit disorder and hyperactivity.

In recent decades, much has changed in the support and treatment reserved for those patients. From a concept of custodial, linked to social exclusion, in which the disability was seen as discriminating element, is now becoming common the approach based on the social integration. It ‘was the work of Franco Basaglia to determine this revolution. The revision of the concept of "mental patient" as "waste" and its restitution to the human condition have found legal justification in the law 180. It has allowed the closure of camps and mental hospitals-has led to the emergence of community mental health centers with a territorial organization. In this way, the patient is placed in a position to acquire and exercise a sufficient level of self-determination.

Today, the disability is defined as a "health condition in an unfavorable environment." The present therapeutic concepts is therefore to provide the support necessary to help patients to overcome the obstacles that life offers them. The person with intellectual disabilities and / or associated psychiatric illness must now be guaranteed a social network that supports, whose actors are the families, referral services, institutions, a proper regulatory framework and the resources of the territory. The network is necessary to support the mentally defective, but is itself that is enhanced of feelings and friendship of which are rich in these patients.

The postmodern emotional inhibition which we – so-called "normal" – we are affected is often distorted by the spontaneous affection of the mentally ill. People with a brain disability, but with a heart of great intelligence. This wealth is gathered and appreciate the moments of listening and dialogue with their problems and their needs. Intelligence of the heart received and understood only by those who are really close to them.

Realized by Martina Delser

Massimiliano Fanni Canelles

Viceprimario al reparto di Accettazione ed Emergenza dell'Ospedale ¨Franz Tappeiner¨di Merano nella Südtiroler Sanitätsbetrieb – Azienda sanitaria dell'Alto Adige – da giugno 2019. Attualmente in prima linea nella gestione clinica e nell'organizzazione per l'emergenza Coronavirus. In particolare responsabile del reparto di infettivi e semi – intensiva del Pronto Soccorso dell'ospedale di Merano. 

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