What is it about?
People experiencing mental health difficulties often need more than medical treatment. They may also need support with housing, employment, relationships, and everyday life. Yet health and social services frequently operate separately, making it harder to provide coordinated, continuous care. This article introduces RISMe-T (Integrated and Stepped Territorial Mental Health Network), a proposed framework for bringing mental health and related human services together within a coherent community-based system. RISMe-T organises services across four levels of care intensity, supported by shared governance, integrated information systems, and the active involvement of service users and families. Drawing on international guidance and the Italian experience of community mental health reform, the article explores how services could be organised around people’s changing needs rather than institutional boundaries. The model offers a starting point for planning, adapting, and evaluating more connected, recovery-oriented, and equitable community mental health systems.
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Why is it important?
Fragmented mental health systems can leave people navigating disconnected services, experiencing gaps in support, or receiving care that does not match their changing needs. RISMe-T offers health administrators, clinicians, and policymakers a structured way to think about service integration, levels of care, shared responsibilities, and participation in decision-making. Its relevance extends beyond Italy: the framework may help communities examine how mental health care connects with wider health and social support systems. RISMe-T is a conceptual model, not an intervention with demonstrated effectiveness. Its practical contribution lies in providing a framework for local adaptation, implementation research, and the evaluation of more coordinated, person-centred services.
Perspectives
The question behind this article is straightforward: if mental health is inseparable from everyday life, why do we still organise so much of our response through separate services? As a psychiatrist working in Italy’s public mental health system, I believe that community care needs to be understood not simply as a collection of facilities, but as a coordinated network of relationships, resources, and responsibilities. RISMe-T is an attempt to translate that perspective into a practical framework for service design. I do not see it as a universal blueprint. Rather, I hope it can encourage dialogue among clinicians, researchers, policymakers, service users, and families, and provide a basis for local adaptation and critical evaluation.
MD Paolo Camera
ASST Nord Milano
Read the Original
This page is a summary of: Designing Integrated Community Mental Health and Human Services Networks: The RISMe-T Territorial ModelConcevoir des réseaux intégrés de santé mentale communautaire et de services à la personne : le modèle territorial RISMe-T, Canadian Journal of Community Mental Health, September 2026, Canadian Periodical for Community Studies,
DOI: 10.7870/cjcmh-2026-004.
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