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HEALTH

How is Italy addressing its pandemic-induced mental health crisis?

After two years of being battered by the coronavirus pandemic, Italy is in the midst of a mental health crisis. How is the country facing up to the problem?

Italy's young people have been particularly hard hit by the effects of the pandemic.
Italy's young people have been particularly hard hit by the effects of the pandemic. Photo by Priscilla Du Preez on Unsplash

Italy was hit early and hard by the coronavirus pandemic, and – as in the rest of the world – people across the country have spent the last two years struggling to cope with the fallout.

There are now widespread reports of a mental health crisis in Italy affecting younger people in particular.

Recent studies show that an estimated one in four adolescents now has symptoms of clinical depression and one in five are showing signs of anxiety disorders.

In January 2021, the Bambino Gesù paediatric hospital in Rome reported a 30 percent increase in hospitalisations of children aged between 12 and 18 due to self harm after the first wave of Covid.

Italy’s government and regional authorities are now taking steps to grapple with the population’s declining mental health; but is enough being done?

The scale of the problem 

According to a recent study conducted by the mental health charity The Bridge Foundation (Fondazione The Bridge), the period between March 2020 and May 2021 saw a 68 percent reduction in adherence to treatments and a 63 percent increased risk of suicide among those already in the care of mental health services in Italy.

In the same period, 95 percent of the general population risked developing symptoms of anxiety, depression and stress, and there was an 85 percent increase in the consumption of non-prescription drugs such as psychotropics and anti-anxiety medications, the report says.

“These are alarming data that cannot be ignored by the government,” the foundation’s president Rosaria Iardino said in a press release published on Wednesday. “The issue of mental fragility must certainly be a priority on the government’s agenda.”

95 percent of Italy's general population is likely to have developed symptoms of anxiety, depression and stress over the course of the pandemic.

95 percent of Italy’s general population is likely to have developed symptoms of anxiety, depression and stress over the course of the pandemic. Photo by Emma Simpson on Unsplash.

A December 2021 survey conducted by the Soleterre Foundation and the Trauma Research Unit of the Catholic University of Milan based on a representative sample of 150 young people aged between 14 and 19 found that 69.3 percent of those interviewed felt the pandemic had become a part of their identity, and 64 percent said that it had made them a different person.

34.7 percent had trouble getting to sleep at night, and almost one in five (17.3 percent) said that they felt it would be better to die or had considered self-harm.

Italy’s Health Minister Roberto Speranza acknowledged the problem over the weekend in an interview on the Rai talk show Mezz’ora in più (Half an Hour More), saying “the issue of mental health is crucial for the coming months.”

The current state of mental health services in Italy

Italy’s healthcare system is decentralised, operating on a regional rather than a national level and administered by local health authorities (Aziende Sanitarie Locali, or Asl) – meaning there are substantial variations in service provision depending on where in the country you’re based.

In 2020, Massimo Di Giannantonio, president of the Italian Society of Psychiatry, estimated that Italy’s local health authorities on average allocate just 3.2 percent to 3.3 percent of their budget to mental health, compared to upwards of 7 percent to 8.5 percent in places like Germany, France, and the UK.

Some Italian regions are taking their own initiatives to improve mental health outcomes.

People’s experience of mental health treatment in Italy will vary depending on where they’re based. Photo by Ümit Bulut on Unsplash

Some Italian regions, however, are further ahead of the game than others.

In August 2020, Campania introduced a regional law granting all residents the right to be assigned a psicologo di base or ‘primary care psychologist’, the mental health equivalent of a GP, through their Asl.

The Office of the Italian Prime Minister appealed against the law on the basis that it was unconstitutional (arguing that such a step can only be taken at national level), but in December 2021 Italy’s Constitutional Court issued a ruling confirming its legality – meaning that as of 2022, Campania’s residents should all have access to a state-funded psychologist.

Campania’s regional authorities have so far allocated €600,000 to the initiative over the next two years, and have announced plans to hire more psychologists to fill positions that the programme will create.

In a press release published on its website, the Campania region said the move is aimed at “intercepting and managing the behavioural and emotional problems deriving from the Covid 19 pandemic,” as well as “intercepting the psychological wellbeing needs that often remain unexpressed by the population”.

What’s Italy as a whole doing to combat the crisis? 

On Thursday, Italy announced plans to introduce a €10 million ‘psychologist bonus’ (bonus psicologo) to help people struggling with the effects of the pandemic to access mental health services as part of the new milleproroghe budget amendment bill, which is currently going through parliament.

If the proposal is passed, the funds will be made available via individual vouchers of up to €600 per person. As part of the plans, the bonus psicologo would be accompanied by an additional €10 million dedicated to strengthening existing health facilities and recruiting new mental health professionals.

The news of the bonus’s inclusion in the bill was met with praise by a number of public figures and politicians, with Democratic Party MP and former president of the Italian Chamber of Deputies Laura Boldrini saying it “meets the needs of many people, especially young people, who have experienced and are experiencing discomfort.”

Some, however, were less impressed, as news outlets noted that the €10 million budget proposed for the psychologist bonus would benefit just 16,000 people; less than 0.0003 percent of Italy’s population of 59.5 million.

"16,000 people? How do you participate in these hunger games? I want to laugh but I just cry #bonuspsicologo"
Tweet reads: “16,000 people? How do you participate in these hunger games? I want to laugh but I just cry #bonuspsicologo”

An early draft of Italy’s 2022 Budget Law had reportedly contained plans to allocate €50 million to a ‘mental health bonus’, which were later scrapped – prompting Rai News journalist Francesco Maesano to launch an online petition campaigning for its reinstatement that has so far garnered over 317,000 signatures.

In response to Thursday’s news, Maesano wrote: “We wanted more resources, certainly, and we’ll be back to ask for them. But the path has been set and it’s the right one.”

He added that the petition would remain up, with the intention of putting pressure on the government to ‘enhance and renew’ the bonus in the coming years.

Alternative measures

Like Campania, some regions have already taken matters into their own hands when it comes to providing post-pandemic mental health treatment.

The region of Lazio in January announced that it was allocating €2.5 million to implement its own psychologist bonus scheme – a portion of the €10.9 million that the region has reportedly ringfenced for mental health over the next three years.

Following the December 2021 Constitutional Court judgement, Lombardy is now also set to follow Campania’s lead in establishing a network of a primary care psychologists, with Lombardy’s Regional Council reportedly voting unanimously in favour of the motion in January 2022.

In a triumphant Facebook post published on the day of the vote, Lombardy regional councillor Niccolò carretta wrote “IT’S DONE!… Soon every Lombard will have a local, trustworthy, accessible, daily and above all free psychological support service at their disposal”.

The government, meanwhile, insists that the €10-million-euro psychologist bonus is just a first step.

‘We need to be careful about thinking that we’ll solve the problems with the bonus, because there is a need for more resources for psychological assistance through systemic action,” Speranza acknowledged in his interview on Mezz’ora in più.

“The bonus is an initial signal.”

If you’re dealing with thoughts of suicide, help is available:

  • The Befrienders Worldwide helpline welcomes calls from anywhere in the world, seven days a week.
  • For Italian speakers, Telefono Amico’s crisis hotline is open between 10am and midnight every day: call 0223272327 to speak to someone.

Member comments

  1. One of the best ways to deal with the mental-health crisis emerging from the plague is to ditch the mask mandates. Two years of not being able to read people’s expressions is causing great harm, especially to our children. Society now sees robots–faces that lack emotion. Google the mental and physical health importance of smiling AND perceiving smiles.

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COVID-19 RULES

Is Italy’s government planning to scrap all Covid measures?

The new Italian government has announced the end of some remaining Covid health measures. Here's a look at what will - and won't - change.

Is Italy’s government planning to scrap all Covid measures?

Few Covid-related restrictions remain in Italy today, six months after the nationwide ‘state of emergency’ ended.

The previous government had kept only a handful of precautionary measures in place – which the new government, led by Giorgia Meloni, must now decide whether or not to keep.

The cabinet is holding a meeting on Monday and will issue a decree this week detailing any changes to the health measures.

Many expect the government to scrap all measures entirely by the end of the year, after Meloni and her party criticised the way Mario Draghi’s administration handled the pandemic throughout its tenure. 

Meloni clearly stated in her first address to parliament last Tuesday that “we will not replicate the model of the previous government” when it comes to managing Covid.

READ ALSO: Five key points from Meloni’s first speech as new Italian PM

While she acknowledged that Italy could be hit by another Covid wave, or another pandemic, she did not say how her government would deal with it.

Meanwhile, new health minister Orazio Schillaci issued a statement on Friday confirming the end of several existing measures, saying he “considers it appropriate to initiate a progressive return to normality in activities and behaviour”.

Workplace ban for unvaccinated medical staff

Schillaci confirmed that the ministry will allow doctors, nurses and other healthcare professionals to return to work after being suspended because they refuse to get vaccinated against Covid-19.

Those who refuse vaccination will be “reintegrated” into the workforce before the rule expires at the end of this year, as part of what the minister called a “gradual return to normality”.

They will be allowed to return “in light of the worrying shortage of medical and health personnel” and “considering the trend of Covid infections”, the statement said.

Fines issued to healthcare staff aged over 50 who refused vaccination would also be cancelled, it added.

There were some 1,579 doctors and dentists refusing vaccination at the end of October, representing 0.3 percent of all those registered with Italy’s National Federation of the Orders of Physicians, Surgeons and Dentists (Fnomceo) 

Daily Covid data reports

Schillaci also confirmed in the statement that the health ministry will no longer release daily updates on Covid-19 contagion rates, hospital cases and deaths, saying this would be replaced by a weekly update.

It said it would however make the data available at any time to relevant authorities.

Mask requirement in hospitals to stay?

The requirement to wear face masks in hospitals, care homes and other healthcare facilities expires on Monday, October 31st.

At a meeting on the same day the government is expected to decide whether to extend the measure.

READ ALSO: What can we expect from Italy’s new government?

While the government had looked at scrapping the requirement, it reportedly changed stance at the last minute on Monday after facing heavy criticism from health experts.

Media reports published while the meeting was in progress on Monday said government sources had indicated the measure would in fact be extended.

Confirmation is expected to come later on Monday.

Italy’s face mask rules in care homes and healthcare facilities are up for renewal. Photo by Thierry ZOCCOLAN / AFP

‘Green pass’ health certificate

There is no indication that the new government plans to bring back any requirements to show a ‘green pass’: the digital certificate proving vaccination against or recent recovery from Covid, or a negative test result.

The pass is currently only required for entry to healthcare facilities and care homes, and this is expected to remain the case.

‘Dismantling the measures’

Some of the confirmed changes were strongly criticised by Italy’s most prominent healthcare experts.

Head of the Gimbe association for evidence-based medicine, Nino Cartabellotta, said the focus on cancelling fines for unvaccinated healthcare workers was “irrelevant from a health point of view .. but unscientific and highly diseducative”.

He told news agency Ansa it was “absolutely legitimate” for a new government to discontinue the previous administration’s measures, but that this “must also be used to improve everything that the previous government was unable to do”.

The government should prioritise “more analytical collection of data on hospitalised patients, investments in ventilation systems for enclosed rooms … accelerating coverage with vaccine boosters,” he said.

However, the plan at the moment appeared to be “a mere dismantling of the measures in place,” he said, “in the illusory attempt to consign the pandemic to oblivion, ignoring the recommendations of the international public health authorities”.

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