Mental health: Bolzano tops the care rankings, whilst Abruzzo comes last

Care for people with mental health problems in Italy is a “case in itself”: in the sense that the efficiency and availability of care do not reflect the scores awarded to the regions by the general monitoring of Essential Levels of Care, conducted by the Ministry of Health across hospitals, local communities and prevention, and based on 22 ‘core’ indicators. The result is that, in the field of psychiatry, Italia remains split in two – with the top four regions located in the north-east – yet those same regions do not, in turn, occupy the top positions in the overall LEA rankings.
The portrait of a country in which mental health – one of the major national emergencies – continues to be treated with varying degrees of sensitivity and attention, even in regions that are otherwise highly efficient in other areas of healthcare, is the most interesting feature highlighted by the latest report from the SIEP, the Italian Society of Psychiatric Epidemiology, presented in Rome to the Chamber of Deputies and based on an ‘index’ developed specifically to assess performance.

But in the meantime, let’s see who has ‘moved up’ and who has ‘moved down’ compared with the previous 2023 ranking. In the top four positions we find Bolzano (at the top of the list), followed by Liguria, Friuli-Venezia Giulia and the Province of Trento. In the bottom four places are Lazio, Sardinia, Molise and, finally, Abruzzo.
A ranking which, as mentioned, is somewhat surprising: Piedmont, Lombardy and Veneto – among the regions with the highest overall LEA scores in Italia – ‘drop’ down the rankings when it comes to mental health. Veneto, which ranks first in all three LEA macro-areas, is in 14th position in the mental health index. This demonstrates, according to the Scientific Society, that a good regional healthcare system does not in itself guarantee a good psychiatric network. Meanwhile, in 2024 (the last year considered), out of 21 regions, 9 have moved up the rankings, 7 have fallen and 5 remain stable. The regions showing the greatest improvement are Tuscany and Campania (+9 places), followed by Calabria (+8) and Piedmont (+7). Molise (8–13) and Valle d’Aosta (-12) have plummeted, falling from the top positions to the middle/lower part of the ranking. The ‘top’ autonomous province of Bolzano remains stable, retaining first place, as do Emilia-Romagna (6th place) and Basilicata (13th place).

Overall – as stated in the summary document presented by SIP – the Report “paints a picture of mental health in Italia that is both encouraging and alarming: encouraging, because it shows how some regions with limited resources nevertheless manage to achieve commendable results through the efficient use of available resources, and how others are making significant progress compared with the previous year; alarming, because the weak correlation with the overall picture of the Essential Levels of Care (LEA) indicates that mental health remains, in many regions, an area that does not receive planning attention commensurate with its epidemiological and social burden, and because the persistent gaps in data from some regions still prevent a complete and fully reliable picture of the system as a whole”. The key priority, therefore, is to ‘fill these gaps’, so that the assessment can lead to a genuine improvement in the care provided to people with mental health conditions throughout the country.

In addition to indicators such as the number of beds available, staffing levels, readmissions within 30 days of discharge and the average length of stay in psychiatric wards, one of the most sensitive figures under scrutiny – given its impact on patients – is the use of compulsory health treatment: the national rate is 0.9 per 10,000 inhabitants but varies from 0.1 in Bolzano to 1.5 in Valle d’Aosta. Another key indicator is per capita spending on mental health, which ranges from 37 euros per year in Campania to 115 euros in the Autonomous Province of Bolzano, whilst the national average is 75 euros.

“The SIEP 2026 Report is not a school report,” says Fabrizio Starace, president of the Society. “It is a tool that the regions can use to understand where action is needed, and that citizens can use to understand what to expect from their mental health service. The data show that regional differences do not depend solely on the resources available, but on how those resources are organised. They also show that some regions are still failing to provide complete data: an issue that concerns transparency towards citizens, even more so than the statistics themselves.”