World Day

Mental health: the challenge of building a genuinely community-based support system

The regional network of community care homes must be integrated with the work of the departments and centres dedicated to patients, who must be involved in the planning of services

by Guido Di Sciascio*, Antonio Vita*

9 October 2026

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3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

Mental health cannot be confined to the settings traditionally designated for psychiatric care. Mental health issues must be identified earlier, closer to where people live, by developing pathways capable of guiding them towards the most appropriate level of care. But bringing mental health care closer to the community does not mean creating new, separate services. On the contrary, it means linking together what already exists with what the National Health Service is developing.

This is one of the most significant challenges we face. The Italian model stems from Law 180 of 1978 and from a principle of deinstitutionalisation which is now also reflected in international guidelines: care should be provided within the community as far as possible, through accessible, integrated and person-centred services.

The local area as an opportunity

From this point of view, the new local support network could represent a great opportunity. There are 1,715 community centres planned across Italia. At present, 781 have at least one active service and, of these, 334 – 42.8 per cent – offer mental health support services. However, only 66 are fully operational in accordance with the required standards. These figures illustrate a system that is still under development, but they also point the way forward for our work.

This network must not replace the Mental Health Departments and Mental Health Centres, which remain the specialist points of reference for patient care. It must work in tandem with them, alongside general practice, family counselling centres and social services, through multi-professional teams and clear organisational links. In Italia, there are around 1,200 Mental Health Centres (CSMs). Once fully operational, when all the Community Homes are up and running, we will have almost one CSM for every Community Home. Building a stable relationship between these facilities is therefore a realistic objective.

The figures

The figures from the Departments show just how essential this is. In 2024, nearly 850,000 people were supported by the DSMs, and over 10 million services were provided. There were around 275,000 new admissions during the year, and for 260,000 people, this was their first ever contact with mental health services. Yet 81.7 per cent of services are still provided at service centres, with only 8.3 per cent delivered at home.

Bringing mental health closer to people therefore means improving our ability to identify mental health issues at an early stage, facilitating access and ensuring, where necessary, appropriate referral and specialist care. This is the community-based psychiatry we need: not a new tier of care, but a network capable of ensuring continuity between primary care, the local community and the DSM.

The role of patients and their families

Finally, there is another equally important change, to which World Mental Health Day 2026 is dedicated. People who have personally experienced a mental health condition and their families cannot be regarded merely as recipients of care. Their experience must inform the design, delivery and evaluation of services.

Here, too, things are changing: of the 781 community centres with at least one active service, 544 report that citizens are actively participating and involved in the development of local services. This is a cultural shift that must extend not only to care provision, but also to the training of professionals and to research.

It is also to draw attention to mental health and bring it ever closer to the lives of our communities that, to mark World Mental Health Day, the Italian Society of Psychiatry is renewing its long-standing initiative by illuminating buildings and monuments across Italia in green. A symbolic gesture which, year after year, aims to remind us that mental health affects us all and must have a place in the life of our cities.

Developing services in collaboration with patients and their families – rather than simply for them – and building a network in which local services and specialist care are not separate spheres are, ultimately, two parts of the same challenge: bringing mental health care closer to people and their real needs.

* Co-Presidents of the Italian Society of Psychiatry

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