Mental health, young alarm: 75,000 new patients are under 35

The youth emergency, the lack of personnel, the extreme variability between regions. This is the triple figure that leaps to the eye when reading the Mental Health Report 2024, just published by the ministry headed by Orazio Schillaci. A picture of psychiatric care in Italia, which however - as stated in the document's introduction - will have to be calibrated and enriched, with 'useful indicators' to monitor the new lines of intervention envisaged by the National Action Plan for Mental Health (Pansm) 2025-2030 launched by the Unified Conference and wanted by Schillaci after 13 years without strategies. A plan heralded as a revolution that will have to take into account the booming discomfort afflicting the country - starting with the new generations, passing through the working-age brackets - the necessary reorganisation of care on the territory, and the historical gap in financial and human resources that afflicts the sector, among the 'Cinderellas' of the NHS. Precisely to reverse the trend, the last budget law allocated 255 million in the three-year period 2026-2028 and 30 million a year starting from 2029. Prevention and personnel are the priorities: 30 per cent of the funds are reserved for the former, while the manoeuvre reserves 30 million per year for doctors, nurses, and other operators for permanent recruitment.

In the meantime, the picture taken by the 2024 Report speaks of 845,516 psychiatric users assisted by the specialist services, with rates ranging from 119.1 per 10,000 adult inhabitants in Marche to 447.2 in Liguria, and compared to an Italia value of 171.9 users per 10,000 inhabitants. Data - incomplete due to the absence of Abruzzo and the only partial sending of Molise - that trace the identikit of a female user in 55.9% of cases with 66.3% of patients over 45 years of age. To this audience in 2024 the psychiatric services - between mental health centres, day centres and residential facilities - provided 10 million services, i.e. just 13.6 per user, mainly on site (81.7% of interventions) and mostly through doctors (28.9%) and nurses (44.1%). They treated disorders with 'important gender-related differences': the rate of schizophrenia, substance abuse and mental retardation is higher in men, while in women depression 'doubles', totalling 46.5 per ten thousand inhabitants.

Beyond the cold numbers, the telltale sign of the emerging discomfort is given by the 'new users', that is, patients who have had contact with psychiatric facilities for the first time ever. In 2024, the report certifies an incidence of 272,497 'new entries' in the Departments of Mental Health, in a puzzle where the boom of Valle d'Aosta (118.5 new users per ten thousand inhabitants), Calabria (106.4x10 thousand inhabitants) and Liguria (100.1x10,000) is counterbalanced in the same year by the 25.7 new users of Marche, the 31.3 of Sardinia and the 33.2 of Tuscany. This is a very wide range, also due to different methods of data collection and interpretation, which it will be up to the Mental Health Technical Table and the Regions themselves to standardise in order to implement targeted and appropriate interventions. Meanwhile, among new users - the majority of whom are women and under 55 years of age - for the very young (18-24 years), particularly high rates are observed: 82.4 per 10,000 inhabitants in males and 105.6 per 10,000 in females. Overall, the under-35s who knocked on the door of a DSM for the first time in 2024 alone number 75,200.

Depression, neurotic or 'somatoform' syndromes such as pain, tachycardia and fatigue, then schizophrenia and psychosis are the first pathologies. A new wave of discomfort, which knocks at the door of the DSMs but also presses 3.3% of the approximately 20,000 total accesses to emergency rooms and to which the National Health Service allocates just 75.2 euros per resident and 33,142 operators distributed over all the public psychiatric operating units. Numbers that the experts themselves slam as 'inadequate' and that need to be made to take off, to really relaunch psychiatry as decided by the new National Action Plan.