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We psychologists very disappointed with the Mental Health Conference

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by David Lazzari

I never expected to have to listen to session moderators define the recent motion passed unanimously by Parliament on mental and psychological health as a chaotic supermarket shopping list and inappropriate comments on psychotherapy schools. I consider all this serious and indicative of a cultural background that does not belong to us and that does not belong to current health policy, to the sensitivity shown in recent months by Minister Speranza

25 JUNEDear Director,

I participated today in the Conference on Mental Health, which arrived with an unclear path, at times and in many ways extremely opaque, both with respect to those who coordinated and made the decisions, and in the passage from the contributions presented to the Table to the document of final synthesis.

I never expected to have to listen to session moderators define the recent motion passed unanimously by Parliament on mental and psychological health as a chaotic supermarket shopping list and inappropriate comments on psychotherapy schools.

I consider all this serious and indicative of a cultural background that does not belong to us and that does not belong to current health policy, to the sensitivity shown in recent months by Minister Speranza and above all it is light years away from the sensitivity of citizens. However, we preferred to be there and say things from the inside rather than desert as other members have done.

As a representative of the 120,000 psychologists, of which 60,000 psychotherapists, also taking into account the positions of the Council of the Scientific Societies of Psychology, I underlined:
1. The lack of coordination and organizational standard for Psychology in the NHS, together with the shortage of personnel (5,000 psychologist executives with an average age of 59, 40% of whom work in mental health) has so far prevented an adequate presence of the profession with respect to the areas of its competence: primary and home care, mental health services, hospital and personal-organization sphere;

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2. This has also affected the mental health services, where the organization is centered only on the discipline of psychiatry, now we also want to emphasize the discipline of child neuropsychiatry, but there is still no structure for the discipline of psychology, called to make an essential and transversal contribution both in adults and in childhood and adolescence.

3. The implementation of the “corporate function of Psychology” finally provided for by law 176/2020 is essential to better organize the presence of psychologists also specifically for mental health services and to allow in this area a real multidisciplinarity and provision an appropriate and effective range of interventions.

4. It should be pointed out that, despite the evidence of efficacy, psychological and psychotherapeutic treatments are widely under-used in mental health services, ending up improperly amplifying the use of drugs.

5. The specific contribution of Psychology is fundamental for a broader and deeper vision of the person with mental disorders, for the understanding and treatment of neuropsychiatric disorders of childhood and adolescence, also with the appropriate involvement of the family. This is true, I want to underline it, even in the most serious situations, which often end up being neglected or entrusted only to the drug, causing the spirit that has brought Italy to the forefront thanks to the reform inspired by Franco Basaglia to fail.

From this point of view, the representatives of the professional and scientific psychological community presented proposals and contributions to the Mental Health Table of which we find some traces in the enunciation of the general principles of the final synthesis document but totally absent in the final synthesis objectives.

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The name “mental health” is in the titles but not in the layout of the document. The resulting picture is disheartening and seems to respond to the proposals and logic of a specific disciplinary area, that of Psychiatry. A fundamental area that we look at with respect but which cannot alone represent the concept and scope of “mental health“.

Health, we know, is a concept that has an important biological dimension, and also a social one. And here I underline the need to strengthen social interventions, the importance of the social network for people with psychological problems, especially serious ones. But if the goal is “health” then we must consider the crucial role of the psychological dimension, which not by chance is placed as a terrain that unites the biological and the social.

The integration is done only in the clarity that seems to be completely absent in the summary document. The result is a fragmented picture that is unlikely to be able to respond to the challenges that the pandemic poses to us. Psychologists are ready to make their contribution to strengthening mental health services for minors and adults, but this will not be possible if the constituent elements of the summary document are not profoundly modified and integrated starting from the proposals we have presented at the table.

We believe it is necessary that these proposals be recovered and integrated in the continuation of the work of the Table, so that Psychology can recognize itself in its works and in its indications. Otherwise we will be forced to make strong choices because it would make little sense to participate in a context that does not include psychological needs.

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We are not passionate about the contrast between strands of psychiatry, because biological and social cannot exhaust a theme that is also psychological or put it in the background. A “biosocial” vision is incomplete if it does not become “biopsychosocial” and does not respond to the real needs and sensitivities of citizens.

David Lazzari
President of the National Council of Psychologists

June 25, 2021
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