When you think about side effects of a situation like the one we are experiencing, our thoughts rightly turn to the numbers of infections, to the health responses, to the attention to the recommended prevention measures, to the progress of the vaccination campaign. But we must never forget the impact that the pandemic causes on people’s minds: for the older ones we talk about infodemia, while for children and adolescents it seems of great importance to pay attention to the signals that the psyche can send to manifest the malaise.
The numbers show that this impact was significant. In the first nine months of 2021 the number of hospitalizations for psychiatric disorders of children and adolescents in Italian hospitals exceeded the total of 2019. Impulse control, self-harm, eating disorders are among the main diagnoses with the greatest increase in 2021, which confirms the increasing trend globally in Italy as well. To launch the call to everyone, parents and families, are the experts of SINPIA – Italian Society of Childhood and Adolescent Neuropsychiatry.
What the figures say
According to preliminary data from the largest international study on the impact of the Pandemic on the mental and physical health of children and adolescents presented at the SINPIA Congress, the mental well-being of minors has decreased by more than 10% globally, doubling of children below the threshold of discomfort and with an increase of anger, boredom, difficulty concentrating, feelings of loneliness and helplessness, stress, sleep disturbances.
Even more serious were the effects of the pandemic for those who already had situations of associated vulnerability or frailty, such as pre-existing neuropsychic disorders, situations of social fragility and economic difficulties, overcrowding, bereavement, migration, inability to access or insufficient electronic means to connect. to DAD and other services. For this group of minors, the worsening was almost double compared to healthy peers, estimated at more than 25%. A certified worsening in Italy by the hospitalization boom in 2021, after in 2020 due to the restrictions for the Pandemic the number of accesses to the emergency room and hospital had dropped by 25%, with fluctuations between 10 and 30% in the various regions.
To date, however, the situation appears critical and SINPIA experts speak of a real wave of return, with more than 85% of hospitalizations in the ward occurring in urgency, for patients with increasingly complex clinical pictures, worsened by the delay in access. to services resulting from the Pandemic. In some regions, 1 in 4 minors are admitted to an adult psychiatry ward due to a lack of neuropsychiatric beds.
Among the further criticalities highlighted, acute psychiatric decompensation in children welcomed in educational and therapeutic residential structures and in unaccompanied foreign minors, due to the intersection between vulnerability and basic post-traumatic aspects and unfortunately often too rigid management by the structures of restrictions, with still significant limitations on activities and contacts with families and with the outside world.
Calls for help must be answered
“We are facing a critical situation – explains Antonella Costantino, president of SINPIA. It is necessary to act immediately to promote mental well-being, to minimize the consequences of the Pandemic on the mental health of the younger generation, to identify the warning signs as early as possible and to be able to offer rapid and appropriate responses to the need.
Over the past decade we have witnessed the doubling of patients followed in the services of Neuropsychiatry of Childhood and Adolescence in the face of continuously diminishing resources, in no other area of medicine has there been such a significant increase. And today, due to the worsening of the pre-existing criticalities of the pandemic and the new clinical problems that are emerging, the asymmetry between the need and the ability to respond has become dramatic “.
In fact, it must be said that in 2020, at least 25% of patients had difficulties in accessing local services. Many Child and Adolescent Neuropsychiatry services have not been able to guarantee continuity of care during the pandemic, through telemedicine activities due to the lack of technological equipment or the non-authorization by individual companies. The introduction of integrated treatment pathways between on-site activities and telemedicine activities, particularly advantageous in some neurodevelopmental disorders, is still very problematic.
.