“You are faced with people who have passed
from the ordeal of the mental hospital to the ordeal of those who get lost in the city.
And this brings us back to addressing the related social problems
to every form of marginalization and which are beyond psychiatry".
Father Luigi Di Liegro
The alert regarding psychological support for the most vulnerable people is high. In recent days, alarms have been raised by the main Italian Neuropsychiatry Departments regarding the increase in mental distress in very young people; the Authority for Children and Adolescents in collaboration with the Higher Institute of Health and the Ministry of Education has started a three-year research on the mental health of children and adolescents in the times of Covid-19 19; The United Nations has issued a warning, with the presentation of the report with guidelines on mental health and covid-19, urging member states to boost global actions for mental health. These are just some of the signs that demonstrate how the pandemic, despite ourselves, has shone a spotlight on the mental health of the population like never before.
Alongside those who today, due to the multiple direct and indirect effects of the pandemic, are experiencing psychological difficulties for the first time, there are also people and families for whom the new psycho-socio-economic difficulties have added to those that began well before March 2020. For many people, psychiatric illness can in fact be compared to a reality of poverty: on a personal level due to the loss of autonomy, social relationships and isolation resulting from the stigma that affects the patient and his family; on a social and economic level, due to the difficulty of having their human and citizenship rights recognized, the right to work, to live independently, to a life project in which they feel like protagonists of their own history.
Those who deal with mental health therefore know that the crisis arrived well before in a healthcare sector which, more than others, has been dealing for years with cuts in resources which affect the methods and times of access to services, the number of local structures, the management of psychiatric emergencies, the funds to be dedicated to rehabilitation activities psychosocial.
The National Mental Health Conference represents for all the actors involved in the discussion on mental health, a moment of exchange, assessment, reflection and proposal. And in this last year and a half more than ever, we have asked ourselves, with an attitude that here intends above all to be constructive and generative, whether the main actor in citizens' care pathways, our National Health System, has sufficient forces and resources to welcome and treat the growing wave of mental distress that began during the pandemic and which with reasonable certainty will continue to increase in the following months.
But the real question to ask is: MUST the public body do it alone?
The Covid-19 pandemic has dramatically highlighted that when resources, investments and a far-sighted and local health protection project, widespread throughout the territories, fail, health care becomes difficult, if not impossible. For mental health this is even more true.
We ask ourselves then, What can private social bodies, voluntary associations, user and family associations do to become supporters and guarantors of a model of territorial and community psychiatry?
We believe that third sector organizations can perform a decisive role in tackling problems where they arise, in the territories, combining the contribution of the public body with the other forces of civil society, the actors of informal assistance, in a dynamic of complementary value and which aims at the integration of multiple levels of intervention. This is the model that the Di Liegro Foundation proposes to promote integrated and coherent care systems in the community and in the territory
The Don Luigi Di Liegro Foundation has been operating in the field of mental health for over twenty years, collaborating with public and private institutions in the implementation of projects, activities and research aimed at promoting psychosocial well-being, the prevention of mental distress and the diffusion of culture and knowledge of mental health.
The Foundation's intervention programVolunteers and Families Networking for Mental Health” is divided into several activities. Among the main ones: training courses on mental health aimed at family members and volunteers to be involved in activities to support users inside and outside the services of the Mental Health Departments; family support groups; Information and orientation services for citizens; projects for the prevention and promotion of psychosocial well-being in schools; research activity.
There are many testimonies from users, family members, citizen volunteers and operators that the Foundation has collected over the course of its years of activity. Not least those of research «Care networks and mental distress» carried out in recent years, which collected and compared the experiential knowledge of users, family members and associations with the professional knowledge of operators and managers of local centers and mental health departments of the entire city of Rome, for a total of over a thousand people interviewed.
From the evidence that emerged from our operational work and research work, the points for reflection emerge that the Foundation presents at the table "The role of user associations, family members and volunteers in mental health services" of the 2nd National Conference for Mental Health: “For community mental health”.
THE PRINCIPLE OF HORIZONTAL SUBSIDIARITY SHOULD NOT BE UNDERSTOOD AS DELEGATION BUT AS VIRTUOUS CIRCULARITY in which each subject contributes by bringing their own experience and expertise. The world of volunteering and private social work cannot and does not want to replace the public body. An effective collaboration must be established between them that leads to the creation of a common good. It is where public service works well that volunteering can be a resource of inestimable value.
IMPLEMENT PROJECTS THAT PURSUIT EFFECTIVE SOCIAL HEALTH INTEGRATION TO SUPPORT RECOVERY PATHS MORE EFFECTIVELY. The role of the private social sector is fundamental in performing a hinge function between the public service and the territory, to offer greater opportunities to respond to the needs of work, home and social life. These are the needs that local services struggle most to guarantee.
PRIVILEGED ATTENTION TO THE YOUNG AGE GROUP: PREVENTION, EARLY INTERVENTION AND SERVICES DEDICATED TO CHILDREN, ADOLESCENCE AND YOUNG ADULTS. Collaborate with educational and socialization agencies to promote emotional and prosocial literacy activities with a view to prevention and education for psychological well-being. Using the peer education methodology and making the children the protagonists of the activities carried out with, by and for them. Training of non-healthcare figures, such as youth workers, who live young people in places of natural aggregation and can play the role of facilitators and liaison with services for the most vulnerable children.
TRAIN AND STRENGTHEN THE FIRST LINES OF INTERVENTION: FAMILY DOCTORS, SCHOOL STAFF, FAMILY COUNSELORS UNFORTUNATELY STILL MARGINAL ACTORS IN MENTAL HEALTH. Devices that are easier for people to access and can and should play the role of antennas in the area. Hence the importance of a structured involvement of associations also in health homes, as a tool for intercepting discomfort and connecting citizens with primary and specialist care services.
ACCOMPANY FAMILIES AND USERS IN THE KNOWLEDGE AND MANAGEMENT OF THE DISEASE. Involve family members and users in training activities capable of providing knowledge and operational tools. Consider users and families as bearers of resources as well as needs and enhance their experiential knowledge. Facilitate measures that allow the effective realization of "after us".
INVOLVE CITIZENS. INFORM, TRAIN AND RAISE AWARENESS IN THE COMMUNITY. Returning to the title of this second conference: For community mental health: by community we mean a "set of people united together by social, linguistic and moral relationships [...], by interests". It is only by involving all citizens, all members of the local community, in the discussion on mental health, that the latter can become an interest of the community and the community a place of effective integration and a tool for fighting stigma and discrimination of people with mental distress.
