The experts promised us: for the Covid infection the turning point will come with mass vaccination and it is the one that the world is looking at among a thousand stop & go. But there is an even more subtle pandemic and for which the vaccine seems even more complicated to find: they are psychic and psychiatric disorders, shot up due to the spread of the coronavirus. A world tsunami, which in an Italy heavily unguarded in terms of services and funding is proving to be dramatic.
To explain it is Claudio Mencacci, co-president of the Italian Society of NeuroPsicoPharmacology (Sinpf) and director of the Neuroscience and Mental Health Department Asst Fatebenefratelli-Sacco in Milan: “The pandemic has created unprecedented stress on Psychiatry services, with a huge increase in requests for services aimed at to face the psychiatric consequences of Covid. But it is more appropriate to speak of syndemia: a mix of clinical and social danger made up of illness, fear of contagion, the so-called Covid fatigue, grief, socio-economic crisis. And the emergence of a profound loneliness, especially among the elderly ».
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The numbers and estimates are wasted: the figure of 830 thousand patients under treatment at the Departments of Mental Health (DSM) photographed in the pre Covid era (and it is just 1.6% of the population taken care of, compared to a expected usage of 5%), it is estimated that today we have to add at least one +30% and overall the syndemia will bring with it a million new cases of mental distress.
Women, young people and the elderly most at risk
“At high risk – explains Mencacci – are above all women, young people and the elderly: the former because they are more predisposed to depression and more affected by social and work repercussions, the latter who have seen their relationship life change and undergo isolation and loss of work, the elderly because they are more fragile in the face of the virus, depression and loneliness. But more generally the entire population is shaken by the uncertainty that messes up the main activity of the brain: the forecasting one, based on the experiences and on the algorithm that we build in our head to live. Since we are social animals, habitual and programmed as a species to give very capable responses in emergencies, the adaptation to this situation, prolonged indefinitely, causes an emotional emptying ».
Welfare shortages
The toolbox with which Italy has found itself to cope with this maxi-emergency in the emergency is decidedly lacking, starting with the staff: a health service deprived for at least 15 years is missing 20% of psychiatrists in the DSM ( in 2018 there were about 5 thousand), as well as 1,500 psychologists, as many psychiatric rehabilitation therapists and social workers, 5 thousand nurses. “Only this year it was decided to bring the specialization grants in Psychiatry from 280 to 400, a number that must now be stabilized and that in any case will produce its effects only in four years”, warns Enrico Zanalda, co-president of the Italian Society of Psychiatry (Sip), director of the Inter-company Department of Mental Health of the ASL of Turin and San Luigi Gonzaga hospital and one of the founders of the National Coordination of Mental Health Departments, structures on which the Higher Institute of Health is not by chance is carrying out an extensive survey on Covid and psychiatry.