Over the last five years, the increase in pressure on mental health services in the Italian regions, especially among adolescents and young people, has grown. Here I am. This is demonstrated by the analysis of the contributions of the regional sections of the SIP (Italian Society of Psychiatry). An operational proposal also emerges from the experts which collects the indications coming from local realities: the establishment of a permanent conference of the Regions to monitor the problems and services, to define immediate and programmable interventions.
But what is the situation? Here’s what the experts report.
Leopard services
The numbers highlight a very differentiated picture. Some regions in the North, such as Emilia-Romagna, Friuli Venezia Giulia and Trentino Alto Adige, show a strong ability to intercept needs and a good supply of local services: in Emilia-Romagna the intake reaches 234.8 users per 10,000 inhabitants, compared to a national average of 171.9, while in the Province of Bolzano it exceeds 327 users per 10,000 inhabitants.
In other areas, however, specific critical issues emerge: Liguria records the highest national prevalence, with 447 users treated per 10,000 inhabitants compared to an Italian average of 171.9, Lazio highlights hospital readmission rates above 20%, while Marche, Abruzzo, Molise and Calabria continue to face a shortage of staff, with resources that in some cases drop to around 40 operators per 100,000 inhabitants compared to a national average of 66.2.
In the South, significant differences also remain in the organization of services, with regions such as Puglia having developed a solid territorial and rehabilitation network and others which still need to strengthen their capacity to take charge. A complex picture, which however confirms how the main inequalities do not rigidly follow a geographical line between North and South, but depend above all on the local organization of services and investments made over time.
“In Italy, mental health affects approximately 15-20% of the population overall over the course of their lives, but the response of services remains uneven. Not so much and not only due to a geographical difference between North and South, but due to the presence and organization of services in the territory: metropolitan areas concentrate skills and structures, while the more peripheral contexts struggle to guarantee continuity and timeliness in taking charge. For this reason it is necessary to strengthen coordination between Regions and establish a permanent conference for monitoring services”
explains Guido Di Sciascio, SIP president and DSM director of the Bari Local Health Authority.
Teenagers and beyond
Access to child and adolescent neuropsychiatry services and emergency rooms for psychiatric reasons has grown significantly in the post-pandemic period, in particular for anxiety disorders, depression and self-harming behaviors.
On the judicial psychiatry front, the REMS (the residences intended for people who have committed crimes) continue to deal with problems that often go beyond the medical context: there are currently around 632 people present in the facilities and around 750 on the waiting list, against a limited availability of places, with waiting times that in some regions even exceed 12 months.
Access to the emergency room and requests for help from mental health centers and child and adolescent neuropsychiatry services are also growing sharply. Numbers also confirmed by the most recent epidemiological data: in 2024, psychiatric users assisted by specialist services were approximately 845,516, with 272,497 people coming into contact with Mental Health Departments for the first time and over 10 million services provided (average 13.6 per user), confirming an increase in mental health needs. In 2024, there were also 636,113 visits to the emergency room for psychiatric reasons (3.3% of the total) and 4,586 compulsory health treatments (TSO). Added to this are the great complexity in the management of psychiatric emergencies and the increasingly relevant issue of the safety of healthcare workers.
What to do upon discharge
Last but not least, the topic of care is also very important for the management of patients, both during hospitalizations and after discharge. The availability of new innovative treatments, both pharmacological and non-pharmacological, should never be patchy or different between the center and the periphery of the Regions.
“A further critical element concerns the availability of the most innovative therapies, which today is not uniform across the national territory. The differences between Regions, already evident in the data on services and care, are also reflected in access to treatments. This translates into uneven treatment paths, in which the quality of care risks depending more on the place of residence than on the clinical need of the person. Ensuring equal access to therapies means reducing these inequalities and ensuring homogeneous standards of care throughout the territory”
Antonio Vita, president-elect of SIP and full professor of Psychiatry and DSM director of the University of Brescia – Spedali Civili, reports.
