Organising Territorial Mental Health Networks for Healthy Communities: A Commentary on the RISMe-T Model

Abstract

Administrators of health and human services are increasingly asked to build “healthy communities” while managing fragmented systems, constrained budgets, and growing mental health needs. Community mental health is central to this agenda, yet many territorial systems remain organised around institutional logics and siloed programmes rather than integrated networks. This commentary reflects on the experience of the Italian mental health reform and proposes the RISMe-T (Integrated and Stepped Territorial Mental Health Network) model as a pragmatic framework for administrators who seek to organise territorial mental health and related human services in support of healthy communities. Grounded in international guidance from the World Health Organization (WHO) and the OECD, as well as Italian policy developments on territorial care and Case della Comunità, the model structures mental health and human services into four levels of care intensity, supported by cross-cutting functions of multilevel governance, information systems, and co-production. This commentary argues that RISMe-T can help administrators move from abstract principles of community-based, rights-oriented care to concrete design choices about governance arrangements, resource allocation, workforce roles, and performance indicators. The commentary highlights three administrative priorities: investing deliberately in lower-intensity, community-anchored levels of care; treating mental health departments as network administrators across health and human services; and embedding co-production as a managerial principle rather than an optional add-on. This commentary concludes with a call to action for administrators, policymakers, and scholars to use system-level models such as RISMe-T as heuristic tools for redesigning territorial mental health networks, evaluating their performance, and aligning them with broader healthy community strategies.