Psychic distress: 2 million people in Italy without treatment

The prevalence of mental disorders is on the verge of surpassing that of cardiovascular disease and, according to the findings of the fifth edition of the World Mental Health Day Report published by Ipsos, these diseases are more frightening than cancer. In fact, almost half (45%) of respondents in 31 countries globally consider mental health to be the top health concern, a significant increase of 18 percentage points over 2018, signalling a growing emergency in health systems around the world.

Numbers worth 4% of the gross domestic product in Italy between direct and indirect expenditure. Not to mention the decrease in life expectancy by 10 years. At a global level, it is estimated that around 12 billion working days are lost each year due to depression and anxiety, costing USD 1 trillion a year in lost productivity. However, the 'pandemic' dimensions reached by mental disorders are not matched by an increase or improvement in treatment services, particularly in our country. Mental Health Departments (DSM), in fact, have decreased in number (from 183 in 2015 to 139 in 2023), and are experiencing a profound staffing crisis, especially medical: it is estimated that one thousand more psychiatrists will be missing next year.

"The reality is that in a decade that has seen a fivefold increase in the number of cases of many psychiatric pathologies, especially among the youngest and the most fragile categories, Italy's mental health sector has found itself in an unequal struggle with a changing society, with fewer and fewer resources, fewer and fewer public facilities, and fewer and fewer personnel, who are abandoning the departments due to a lack of security and professional certainty,' points out Emi Bondi, outgoing president of the Italian Psychiatric Society (Sip) and member of the Ministry of Health's technical panel on mental health. There are now too many cases of daily violence reported, especially in emergency rooms, and no 'bonus' will ever make up for the lack of resources taken away from the public service and from territorial medicine, the real point of reference for the population, which needs structural investments, announced long ago but never made available'.

In Italy, therefore, mental health does not seem to be a priority and there is too much disparity between the need for care and the actual availability of services. And raising the alarm, on the occasion of World Mental Health Day, are also the mental health departments, which are calling for adequate resources and an increase in staffing for a renewed organisational model and relations with the Judicial Authority, while in the Senate the examination of the Zaffini bill, which aims to reform psychiatric care on the territory, has begun with a series of hearings. And according to the National College of Mental Health Department Directors 'mental health needs at least 2 billion more and 30% more staff'.

"One of the most urgent problems for mental health services in Italy is the shortage of economic and professional resources. We call for at least 5 per cent of the National and Regional Health Fund to be allocated to mental health, plus specific percentages for childhood and adolescence (2 per cent) and addictions (1.5 per cent). An investment that would give a great return in terms of care, as well as being a strong development flywheel for the country amounting to at least 2% of GDP,' observes Giuseppe Ducci, vice-president of the College and director of the Department of Mental Health and Pathological Addictions of the ASL Roma 1. It is therefore indispensable for the very survival of the DSMs, to redefine the share of expenditure for psychiatric assistance, which is currently falling to an average of 2.5% of the National and Regional Health Fund, amounting to just over 3.5 billion, making Italy at the bottom of the list in Europe among high-income countries. In order to reach the 5% envisaged by the single State-Regions conference for adult mental health alone, at least 2 billion more is needed, which is essential to guarantee the adaptation of staff to ministerial standards'.