In 2021, 2008 patients were taken care of in Emilia-Romagna (+27.5% compared to the previous year), many of which were minors
12 January 2024 – “We will not leave those suffering from an eating disorder alone, we ask the Government to do the same. Despite the cuts included in the budget law, the Region is committed to guaranteeing the care of these people”. Thus the councilor for health policies, Raffaele Doninireassures patients and their families, worried by rumors of the closure of the centers that deal with these pathologies.
“Our assistance and treatment network will not undergo reductions – explains Donini -, however, a serious problem remains which I will propose to address in the National Health Commission of the State-Regions Conference: the State cannot abandon these citizens, leaving the responsibility completely on the shoulders of the Regions burden of care. For Emilia-Romagna alone we are talking about over two thousand people, including minors who may risk their lives. We have 18% of national public facilities for the treatment of eating disorders in our territory, we cannot accept this heritage being lost. And for other less structured regions the cuts would have even worse consequences.”
What are DNAs: Nutrition and Eating Disorders
Nutrition and eating disorders represent a group of conditions characterized by marked medical and psychopathological impairment, with a direct impact on the development of affected people and their families. L’etiopathogenesis is complex and the difficulty of family management is significant. The onset almost always occurs in developmental age.
These are psychiatric disorders with nutritional and metabolic implications that can lead to I risk my life of those who are affected, with death rates which in the 12-25 year age group are second only to those of road accidents. It is no coincidence that national and international scientific documentation recommends paying maximum attention to gravity and complexity psychiatric, psychological e metabolic–nutritional of the framework, to prepare early and individualized treatment plans that best respond to the needs of the patient, his family and the entire reference context. It’s necessary overcome the fragmented nature of the intervention and promote taking charge with a one-based approach multidisciplinary network integrated services, which can offer all levels of care, from outpatient to residential.
In short, the healthcare challenge is linked to good work multiprofessional teamat the prevention et al early recognition of disordersat the taken charge of the patient and his family, al networking work organized on multiple levels and to research. It is necessary to facilitate the request for help, knowledge, access to care and above all guarantee the stability of the resources used on all levels of care (from outpatient clinics to day services, from daily hospitalizations to intensive or extensive residential rehabilitation).
The national fund cut by the budget law and the risks of failure to finance
The Fund for fighting DNA was established in 2003 and provides a total of 25 million euros on a national scale, of which 1.8 million for the Emilia-Romagna Region. These funds made it possible to stabilize and consolidate the organizational model of the outpatient network based on the multidisciplinary team, support the definition, publication and implementation of the Diagnostic Therapeutic Assistance Path (PDTA) DNA in every local health authorityimplement care treatments based on scientific evidence.
Not only that: the Region was able to apply the reference standards for Urgent metabolic-nutritional hospital admission unit in ordinary hospitalization, carry out a regional training co-designed by the University of Bologna, guarantee interventions to support families.
Instead of consolidating the specialized and competent resources dedicated to DNA processing to ensure the timeliness and continuity of care, failure to refinance would have significantly negative consequences.
Not treating yourself, interrupting treatment or resorting to inadequate treatment can in fact lead to a worsening of the prognosis and increased risk of chronicity. The reduction in the necessary resources would in fact decrease the effectiveness of outpatient treatment with the next major one resort to hospital admissions oa more intensive rehabilitation treatments which present a very high cost for the National Health Service.
To know more
The numbers in Emilia-Romagna
In Emilia-Romagna in 2021, 2,008 patients were treated for eating disorders, between mental health centers (1,379 people) and childhood and adolescent neuropsychiatry (629): an overall increase of 27.5% compared to the previous year (1,575). Some situations become so serious as to require hospitalization: a total of 856 people of all ages, of which 701 women (81.9%). 91.7% (exactly 1,264) of those treated in mental health centers are female, while 115 (8.3%) are male. The prevalence of the female component is also found in the services for taking care of the youngest (Child and Adolescent Neuropsychiatry) with 587 assisted (equal to 93.3%).
As regards age groups, over two thirds of those assisted (1,396, equal to 69.5%) are concentrated between 12 and 30 years old, with an increase of 51.9% overall and of 124.4% among lower than in 2016, also thanks to the Covid pandemic which made itself felt strongly on mental health, in particular on eating disorders, making their onset earlier. In fact, requests for help have increased and pre-existing eating disorders have worsened. In this age group, there were 461 cases in which one or more hospitalizations were necessary.
As for the diagnoses of individual eating disorders, the most frequent problems include: anorexia nervosa which comprises 38.01% of cases and bulimia with 26.5% of cases.
The Region’s commitment to DNA
The Emilia-Romagna Region has long been committed to the prevention and treatment of eating disorders, recognized as a true health emergency. Following the national guidelines, it has adopted an innovative organizational model based on the PDTA Programs (Diagnostic Therapeutic Assistance Path) of Local Health Authorities and University Hospitals. This approach aims to create an integrated network of services that place the person at the centre.
In January 2022, the National Center for Addiction and Doping of the Higher Institute of Health presented the results of the national CCM project “The territorial mapping of centers dedicated to the treatment of nutrition and eating disorders”, presenting the first census of services in Italy outpatient, residential and semi-residential belonging to the National Health Service. In the Emilia-Romagna Region there are 18% of the public structures for DCA in Italy, and 33% of the structures in Northern Italy.
In the regional program for the treatment of Eating Disorders, various professionals and disciplines are involved to guarantee an accurate diagnosis and complete treatment. Interdisciplinary teams work collaboratively to ensure continuity and coherence of treatments and establish solid relationships with specialized centers and structures in the health service network. These multi-professional teams, present in every provincial territory, include psychologists, psychotherapists, psychiatrists, nutritionists, dieticians, nurses and child neuropsychiatrists.
Treatments take place through different modalities, such as outpatient treatment, psycho-nutritional rehabilitation in day hospital or in residence and hospitalization for metabolic emergencies.
The service offered also pays attention to the families of the boys and girls in treatment, especially if they are minors, with support activities in order to make them co-therapists. The collaboration with voluntary and self-help associations is very close, especially to raise awareness of these issues.