Home Health Mental health, two-speed health care between funding and staff shortages

Mental health, two-speed health care between funding and staff shortages

by admin

Fabrizio Starace is a psychiatrist member of the Superior Health Council, director of the Department of mental health and pathological addictions of the Azienda Ausl of Modena and of the Màt festival

Dedicated to the theme of inequalities, this year’s World Mental Health Day was a propitious occasion to reflect on the inequalities that characterize the social and health system in our country. Made even more evident by the pandemic emergency, they sanction – apparently without the possibility of a solution – what with a cynical definition has been called the “postal code lottery”, that is the possibility of exercising one’s citizenship rights-duties according to a variable gradient depending on the Region of residence.

The Regions lag behind

The data of the most recent Mental Health Report published by the Ministry of Health certify it: the abysmal shortage of funds (Italy allocates only 3% of the entire Health Fund to mental health; the United Kingdom – which has a very similar system to ours – it stands at 12% and has foreseen further increases in the next three years) becomes more marked in some Regions (Campania, Calabria, Basilicata and unexpectedly Veneto), posing serious questions about the system’s stability. The same extraordinary investment plan envisaged by the PNRR risks being subjected to the same logic it tries to correct, giving more to those who already have, and less to those who are at a disadvantage.

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The lack of funds

The lack of funds corresponds to a macroscopic shortage of staff, a precondition for community territorial work. Furthermore, the lack of some professional figures (psychologists, rehabilitation technicians) ends up radicalizing a tendency to separate medical interventions and non-pharmacological interventions, which are in fact marginal. It is therefore not surprising that the services received by the people in charge of the Mental Health centers receive 14 services on average per year, but with regional differences of about six times, ranging from 5.3 in Molise to 33.4 in Friuli Venezia Giulia and that 20.2% of the domicile is activated in Tuscany and only 2.1% in Molise.

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Giving a voice to 800,000 patients

How to deal with these inequalities? We believe that alongside a more marked and authoritative verification action on the use and distribution of funds by the Ministry, it is necessary to give voice and real presence to those directly involved: to the more than 800,000 subjects in contact with the services, to the 3 million people who have mental health problems and who do not even turn to services, their families, associations, sector volunteers. With initiatives that foster discussion, the exchange of experiences, that make the spirit of citizenship grow and contrast that dangerous reflection of “it doesn’t concern me” which is the breeding ground of stigma and discrimination. With these objectives, the Modena Mental Health Week was born 10 years ago, a festival that concentrates in seven days over 100 meetings, debates, scientific conferences, but also sporting, theatrical, musical events, film screenings and poetry readings, which they see the theme of psychic discomfort at the center.

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Fighting prejudices

Creating opportunities for direct relationship with those who live or have gone through mental suffering is the most effective method to combat the prejudices that harbor within us, a true antidote to the indifference that dries up our being a community. Màt, this is the name of the festival, will also contribute this year to breaking down the barriers between “healthy” and “sick” by restoring to everyone the awareness that mental health is a common good, in the maintenance of which everyone is called to participate.

Mental health, in Modena the story of mental illness at the time of the pandemic


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