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The prevalence of mental disorders is about to exceed that of cardiovascular diseases and, according to the results of the fifth edition of the World Mental Health Day Report published by Ipsos, these diseases are more scary than cancer. In fact, nearly half (45%) of respondents in 31 countries globally consider mental health their top health concern, a significant increase of 18 percentage points compared to 2018, signaling a growing emergency in healthcare systems around the world.
Numbers that in Italy are worth 4% of the gross domestic product between direct and indirect expenses. Not to mention the decrease in life expectancy by 10 years. Globally, an estimated 12 billion working days are lost due to depression and anxiety each year, costing $1 trillion per year in lost productivity. However, given the “pandemic” dimensions reached by mental disorders, there is no corresponding increase or improvement in treatment services, particularly in our country. The mental health departments (DSM), in fact, have decreased in number (from 183 in 2015 to 139 in 2023), and are experiencing a profound personnel crisis, especially medical ones: it is estimated that next year another thousand will be missing. psychiatrists.
In a decade, cases have increased fivefold
«The reality is that in a decade which has seen a fivefold increase in cases of many psychiatric pathologies, especially among the youngest and most fragile categories, Italy’s mental health sector has found itself fighting on unequal terms with a changing society, with fewer and fewer resources, fewer and fewer public structures and fewer and fewer staff, abandoning the departments due to lack of security and professional certainties – highlights Emi Bondi, outgoing president of Sip (Italian Society of Psychiatry) and member of the ministry’s technical table on mental health of Health –. Too many cases of daily violence have now been reported, especially in the emergency room, and no “bonus” will ever be able to make up for the lack of resources taken away from the public service and local medicine, a true point of reference for the population, which needs of structural investments, announced some time ago but never made available.”
More resources and a new organizational model
In Italy, mental health therefore does not seem to be a priority and there is too much disparity between the need for treatment and the actual availability of services. And the Mental Health departments are also raising the alarm on the occasion of the World Day, asking for adequate resources and an increase in staff for a renewed organizational model and relations with the Judicial Authority, while in the Senate it has been started , with a cycle of hearings, the examination of the Zaffini bill which aims to reform psychiatric care in the area. And according to the National College of Directors of Mental Health Departments “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 scarcity of economic and professional resources. We ask that at least 5% of the National and Regional Health Fund be allocated to mental health, plus specific percentages for childhood and adolescence (2%) and for addictions (1.5%). An investment that would give a great return on the healthcare level, as well as being a driving force for the country’s very strong development equal to at least 2% of the GDP – observes Giuseppe Ducci, vice-president of the College and director of the Mental Health and Pathological Addictions department of the ASL Rome 1 –. It is therefore essential for the very survival of the DSMs to redefine the share of spending on psychiatric care, which is currently falling on average to 2.5% of the National and Regional Health Fund, equal to just over 3 and a half billion which makes the ‘Italy brings up the rear in Europe among high-income countries. To reach the 5% envisaged by the single State-Regions conference only for adult mental health, at least 2 billion more are needed, essential to guarantee the adaptation of the workforce to ministerial standards”.