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

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."

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, 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."

C’è un aspetto del #COVID19 da non sottovalutare: gli effetti sulla salute mentale.

Il #bonuspsicologo va incontro alle esigenze di molte persone, specialmente giovani, che hanno vissuto e vivono un disagio.

Una misura sanitaria giusta, approvata oggi alla Camera.

— Laura Boldrini (@lauraboldrini) February 17, 2022

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.

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.