If there is anyone in danger because of Mental Health it is the so-called ‘Next Generation’, of which there is so much talk, and the relative national GDP. Because this time the counter risks really jumping due to the impossibility of guaranteeing minimum services in a sector that was already on its knees well before the pandemic, with the absence of investments, a dramatic shortage of medical personnel and now also struggling with an increase of 30 % of diagnoses between depression and other psychological pathologies caused by two years of Covid, especially among young people and students: precisely, the Next Generation.
Investments, which should have grown to at least 5% of the national health fund, to reach the 10% target indicated in the EU for high-income countries, have plummeted from the already miserable 3.5% in 2018 to 2, 75% by 2020. An increasing number of post-pandemic diagnoses followed. It means that the 728 thousand citizens treated in the Mental Health Departments in 2020 (which went from 183 to 141 from 2015 to 2020) have certainly increased in 2021-22 even if not registered or not yet identified.
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There is a lack of health personnel
To all this is added the flight of staff, both medical and nursing, from departments already under staff for years. So much so that in 2025 there will be another thousand psychiatrists between retirements and resignations as emerges from a recent study by Anaao-Assomed. Finally, regional differences remain to complicate the situation. Despite some faint signs (in the Budget Law and in the guidelines on DSM) and funding from the EU Commission, there is not a single euro earmarked for Mental Health among the (huge) resources allocated by the PNRR to health. The appeal launched today in Rome by SINPF in an event organized by MAPCOM Consulting with the unconditional contribution of Ostuka Pharmaceutical Italy and Lundbeck Italy and adopted by the other scientific companies in the sector, for the creation of a National Agency, fits into this context. for Mental Health, which will have to start from scratch to put Italy in a position to balance its accounts with Europe and to restore dignity to those who suffer and those who work in this sector which is so strategic for the Italian society and economy.
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by Paola Emilia Cicerone
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A mental health agency
“A national mental health agency can be born on values similar to those of the National Agency for Territorial Cohesion, another historical drama of this country, and can allow this world to start from scratch – they explain. Matteo Balestrieri e Claudio Mencacci, SINPF presidents -. That is, from the census of the world of Mental Health to understand the real numbers of the phenomena, now stopped in 2015, another ‘geological era’, reorganize the services, correctly calculate the real needs for funding, study the rational allocation of these resources and in homogeneous way on the territory, making sure to guarantee levels of care and assistance of proven effectiveness, based on evidence that ensure concrete results, and to guarantee a homogeneous and real functioning of the services to make the right to Mental Health a right enforceable throughout the country without inequalities. Therefore, coordination between the Regions is needed, the definition of shared PDTAs integrated with individual treatment plans, personalized therapeutic rehabilitation projects, greater involvement of local hospital pharmacies in monitoring pharmacovigilance and therapeutic adherence, development and support in all Regions of alternatives to psychiatric structures, allocation of funds for research, the reconstruction of an interministerial and interregional work table. All this with the only real final goal of a National Agency for Mental Health: the recovery of people who suffer “.
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Much remains to be done today. “Unfortunately, the measures adopted so far, while marking an appreciable turnaround, are not able to recover the impoverishment of means and personnel that the Mental Health Services have suffered for years – he specifies Fabrizio Staracepresident of SIEP (Italian Society of Psychiatric Epidemiology -. This requires an immediate effort to connect all institutional levels towards a decisive change of pace: an ‘extraordinary’ ordinary investment, which gradually reaches two percentage points of the National Health Fund and brings back the standard. Mental Health expenditure of at least 5%. An impressive investment (at full capacity equal to 2.3 billion more per year), but with dimensions consistent with epidemiological assessments, international comparisons, regulatory indications. An organic investment , with a system vision but oriented towards the pursuit of a defined number of priority actions. The stability of the ‘Mental Health system’ is not attributable to the sum of fragmentary initiatives, even less if the result of lobbying or corporate pressures. Unfortunately we do not seem to be able to identify, in the significant resources allocated by the PNRR to the Health Mission, chapters dedicated to Mental Health in addition, the absence in Ministerial Decree 71 of clear indications on organizational and personnel standards that allow access to quality care regardless of the Region of residence was immediately filled “.
Prevention
Among the key issues is prevention. “This impoverishment of public services, now below the threshold of survival, means that the capacities and possibilities of early intervention are also reduced, putting prevention activities in serious difficulty, a fundamental element to avoid falling into darkness – he adds Massimo di Giannantonio, president of SIP (Italian Society of Psychiatry) -. In particular, the early recognition of the problem in students, which helps us to have a true knowledge of the phenomenon. Hence the importance of carrying out observation and survey activities in schools, just as it is essential to develop knowledge of drugs and substances “.