Pandemic, young people and mental distress: there is a real mental health crisis underway, especially among the very young, and the pandemic is the triggering cause. The alarm comes from National Congress from the Italian Society of NeuroPsychoPharmacology (Sinpf).
The incidence of depression and anxiety among adolescents has doubled compared to before the pandemic and a large meta-analysis just published on JAMA Pediatrics, which included 29 studies of more than 80,000 young people, showed that today one in 4 adolescents, in Italy and around the world, has clinical symptoms of depression and one in 5 signs of an anxiety disorder. This widespread mental distress risks putting a serious threat on the future health of children.
The probability of mental disorders is particularly high among older children, more than children, they explain
psychiatrists, have felt the effects of the restrictions. All this is also confirmed by a second study on 1,500 children
teenagers, published on Journal of the American Academy of Child and Adolescent Psychiatry. A situation that can
unfortunately have negative consequences in the long term: it has in fact been shown that suffering from depression during
childhood and adolescence is associated as adults with worse health, mental and beyond, and greater difficulties in relationships. It is therefore necessary, in the context of the pandemic, young people and mental distress, to "intercept the distress in young people and intervene with the most appropriate tools".
"All the research agrees: with the pandemic an alarming percentage of very young people are showing signs of a mental distress - explains Claudio Mencacci, co-president of Sinpf and emeritus director of neurosciences and mental health at the ASST Fatebenefratelli-Sacco in Milan - The rates of depression and anxiety that are recorded are directly related to
restrictions: that is, they increase when sociality is prevented, when we have to return to distance learning,
when relationships with peers cannot be cultivated. Those who pay the highest price are the children of upper secondary school, an essential phase for new experiences and for the first goals: not living in normality 'milestones' such as the final exam or the first loves for the psyche of a very young person it is similar to bereavement and as such can be a trigger for anxiety and depression. Many may have symptoms of mental distress that then resolve, but many are showing that they cannot get out of it. Not to mention those who were already fragile before Covid, for whom the pandemic was even more difficult to deal with. Everyone must be intercepted and helped."
And when psychotherapeutic treatment alone is not enough, drugs can also help. "The debate on the prescription of antidepressants in childhood and adolescence is still open: some are approved for use in this group, others are still used off label" - say Mencacci and Matteo Balestrieri, co-president of Sinpf - Antidepressants can and should be administered to an adolescent if it is appropriate, but careful monitoring and a treatment path that takes into account the emotional and cognitive situation is always necessary".
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The Di Liegro Foundation has been operating in the field of mental health since 2006, 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 dissemination of culture and knowledge of mental health. Over time, this commitment has focused in particular on youthful distress, organizing thematic training courses, emotional literacy projects and training courses peer education in schools, research activities.
The observation that mental health in the young age group, a crucial moment in development and for the onset of possible developmental difficulties, is in fact a topic of great importance and on which it is necessary to act in terms of information, protection and prevention, was further validated by2018 edition of World Mental Health Day, dedicated to “young people and mental health in a changing world”.
In fact, data from the World Health Organization underline that 10-20% of children and adolescents worldwide suffer from depressive disorders and that neuro-psychiatric pathologies are the main cause of disability in young people in all WHO Regions. One in six adolescents aged 10-19 suffers from mental disorders. Furthermore, 50% problems begin before the age of 14, but most cases go undetected and untreated. And again: suicide is the third cause of death among young people between 15 and 19 years old.
There is a real risk that mental health problems developed during adolescence may continue into adulthood or even become chronic (WHO, 2005).
From these considerations comes the Foundation's commitment to paying particular attention to youth age group. The actions undertaken have the aim of strengthening, through direct and indirect interventions, protective factors so as to prevent the development of mental health problems.
Projects and initiatives of the Di Liegro Foundation for young people:
The pandemic has increased inequalities which risk making the already precarious mental health of the most disadvantaged social groups increasingly fragile, but the Covid vaccine is starting to reduce anxiety and mental distress.
"The pandemic immediately led to an exacerbation of existing inequalities, with greater incidence and outcomes of the disease in the weakest groups - declare Massimo di Giannantonio and Enrico Zanalda, co-presidents of the Italian Society of Psychiatry - The inequalities generated by the consequences of the lockdown have also had repercussions on mental health, increasing mental distress especially among the more fragile segments of the population, with less access to care and services whose repercussions are still being felt".
However, some changes are starting to be seen in the mental health of the general population following the anti-Covid vaccination. "We are experiencing the first signs of a reduction in some degree of pandemic anxiety and depression - add di Giannantonio and Zanalda - The population is starting to feel more confident about the future and sure of emerging from the catastrophic effects of the Coronavirus, especially now that the anti-Covid vaccine is available which gives us hope of moving away from the risk of a new 'Red October', of new isolations and closures which have weighed heavily on the mental health of the entire population community, especially of the most fragile individuals with more mental problems at the start".
The mental health numbers in the world are impressive, almost a billion people live with a mental disorder in poor countries, over 75% of people receive no assistance. Every year over a million people die from substance abuse and in conjunction with Covid the data appears disturbing to say the least: one in 4 young people aged 18-24 years (25%) declared that they have increased the use of substances to coping with Covid-related stress. Every 40 seconds a person takes their own life and in 2020 suicides increased, just think that in Japan from June to October 2020 they grew by 16% compared to the same period in 2019. About half of mental health disorders begin at age 14.
Access to mental health services remains riddled with inequalities, with something like the 85% of people with
mental disorders in low- and middle-income countries unable to access dedicated assistance. "But also
in rich countries things are not better, including Italy - experts underline - and the pandemic has complicated it for many
wait for this situation. The most fragile people who already had mental health problems with Covid had greater difficulty accessing health services (24% more than the general population), a higher probability of 33% of suffering therapeutic and prescribing interruptions and greater work problems with a higher risk of losing it than 12%".
These are the data that emerged from a study published in The British Journal of Psychiatry, which once again underlines how the
pandemic has had a significant impact on the health and quality of life of the most vulnerable with mental health problems, exacerbating the
inequalities.
"The pandemic risks paving the way for a global mental health crisis that will also affect future generations with long-term repercussions - say di Giannantonio and Zanalda - This is why it is important to intercept and ride the
signs of hope that come from the possibility of emerging from the Covid nightmare through the vaccine. A study confirms this
recently published in the magazine Plos One and conducted at the Center for Economics and Social Research of the University of
Southern California showing that those who have received at least one dose of the vaccine say they are more optimistic about the future, resulting in a decrease in perceived anxiety and depression."
Source: http://direnl.dire.it/psicologia/anno/2021/ottobre/12/index.php
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In the context of European youth policies, Youth Work experiences have taken on a central and increasingly better defined dimension in recent years. Faced with the difficulties of arriving at univocal and shared definitions in the various European countries, which differ in history, culture, legislation and organizational aspects, the idea is gaining ground that these differences represent an asset rather than an obstacle to knowledge and implementation . From comparison and exchange, stimuli can therefore arise for an increasingly broader debate and for the transmission of knowledge, with the aim of deepening skills in the various fields of possible application of Youth Work.
Download the European report on the skills of youth workers and the needs of young people
In the Project Youth Worker Promoting Mental Health (YouProMe), in particular, the objective is to focus on the potential of Youth Work in the field of young people's mental health. Youth distress is a topic with many facets: from various problems linked to contextual, socio-economic and cultural situations, to those that originate more specifically from the onset of a psychiatric pathology. Often these problems converge in the single individual and their addition constitutes a challenge for the agencies that society delegates to deal with them: schools and social and health services. Mental distress has its origins and development in youth. Late or partial interventions in this field risk, as is known, producing negative consequences for the rest of life. On the other hand, educational and socio-health institutions show their limits in the face of this mandate, as their field of action often remains confined within the spatial and relational perimeters of their institutional structures, remaining far from natural places for young people to live, where problems manifest themselves and produce their effects; but also where resources, opportunities, strengths can be grasped, recognized and supported, and where emotional and social skills can consolidate and constitute a barrier to the risk of isolation and drop-out.
This is a field, therefore, in which the role of the youth worker can be crucial, in collaboration with other agencies such as schools and mental health services.
The YOUPROME project it therefore combines the interest in Youth Work and the field of mental health with the primary objective of deepening the skills and methods of intervention of this figure so as to better identify its specific identity and the necessary "tool bag". As the first output of the project, a research report was published which represents the first of a series of tools/tools that the project makes available to Youth Workers who intend to support young people who experience hardship.
Recipients: volunteers, family members of people with mental distress, workers in the healthcare sector and help desks, university students.
The training course, organized by the Di Liegro Foundation, "Volunteers and families networking for mental health" is now in its 15th edition. This year we want to induce a reflection on the theme of the Community and how the spread of Covid-19 has highlighted various psycho-socio-economic problems that require urgent responses.
“A healthy social life can only be found when everyone's virtues live in the entire community.”
Rudolf Steiner
The shortcomings of the healthcare system, the weight of economic and social inequalities, pollution, the progressive reduction of biodiversity and the resurgence of psychological problems that have affected all ages. Volunteering can help remedy the critical issues that have emerged thanks to the importance it is recognized in welfare systems.
A private resource that has joined the traditional tools of public welfare by participating in the provision of social and educational services and in the planning and planning of social and health policies at different levels.
Youth volunteering, in particular, presents aspects of interest for the social sciences: it is a form of active citizenship, it contributes to social well-being, it promotes the maturation of young people, the acquisition of skills and their employability in the job market.
>>> SIGN UP FOR THE "VOLUNTEERS AND FAMILIES ONLINE" TRAINING COURSE
Registrants will then be contacted by our secretariat to confirm participation and pay the participation fee.
The training course will take place in person, at the headquarters of the Di Liegro Foundation, located in via Ostiense 106 (Rome) and online on Zoom.
The contribution is 40 euros, 25 for students, in the form of a donation to the Di Liegro Foundation, deductible from your tax return.
October 9, 2021
Educational agencies of the third millennium, school and family between crisis and opportunity
Tiziana Sallusti, Headmaster of Liceo Mamiani in Rome
Annalisa Giannotti, Clinical Educator
October 23
From the polis to the virtual community: the centrality of human relationships
Jose Mannu, Psychiatrist
November 6, 2021
History and perspectives of mental health services
Giuseppe Nicolò, Psychiatrist Director of the Mental Health Department of ASL Rome 5
November 20, 2021
From the old to the new world, the paradigm shift in psychiatry
Jose Mannu, Psychiatrist
December 4, 2021
Volunteer today, with an eye to the future
Valerio Pieri, Professor at the Department of Business Economics at Roma TRE University
December 11, 2021
Mental health and territory, a new idea of community
Gemma Brandi, Psychiatrist, Director of SOC Health in prison, AUSL Tuscany Centre
January 15, 2022
Addictions, the educating community as a response to complexity
Alessandro Vento, Psychiatrist, Head of the "Addiction Observatory", ASL Roma2
>>> SIGN UP FOR THE TRAINING COURSE
“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.
According to the World Health Organization (WHO), there are 17 million Italians with mental disorders.
Of these, only 25% access public mental health services. Always according to theWHO, Italy has 5.98 psychiatrists and 3.8 psychologists per 100 thousand inhabitants, compared to 830 thousand users with psychiatric difficulties. This translates into a staffing deficit within the mental health system, which varies from 25% to 75%.
A critical condition that has been further aggravated by the pandemic, if you consider that half of the population reports increasing stress and 16.5 percent show symptoms of depression (from the Italia in salute Foundation).
Taking inspiration from these and other data, and in the wake of the motion presented by the majority and approved by the Chamber of Deputies, a group of deputies from the minority also presented a motion which commits the government to a substantial list (27 points) of activities all aimed at a profound improvement of the public service system mental health.
Among the first points of the motion, the urgent definition of a National plan for the protection of mental health
and the promotion of psychological well-being; Lupdating of essential levels of assistance, with the inclusion in the grid of tools to also evaluate mental health pathways in the area, and not just in hospital, and ensuring real differentiation in the provision of care and intervention models. They are still expected initiatives to increase the share of spending for mental health departments, which has remained at 3.5 percent of the regional health fund for over 20 years, i.e. just over 4 billion euros, and actions aimed at relaunching mental health and psychological well-being protection services, favoring a territorial network to integrate public offers and proposals from the so-called private sector
social.
The deputies who signed the motion then underline the need to identify uniform qualitative, technological and organizational standards of the network of mental health centers and strengthen the supply of specialist staff in the field of mental health. There is no lack of attention to the strengthening and efficiency of territorial networks, in terms of integration both between the public, private and private-affiliated sectors and with the network of social and health services, and to the promotion of the home as the first place of care. A specific space is dedicated to the developmental age with the request to include the figure of the psychologist within the paediatrics and neonatal departments of the hospitals of the National Health Service; to grant families with dependent children under the age of 18 a voucher intended to facilitate access to psychological and psychotherapeutic services for the most vulnerable segments of the population; to introduce the figure of school psychologist in schools of all levels and, finally, to guarantee theincrease in the number of beds in public mental health services and in child neuropsychiatry departments. The objective of the commitments requested from the government by the deputies is, in conclusion, recognize the right to psychological health for all citizens.
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"From March to December 2020, the number of children in juvenile justice for violence against family members increased by 41%. The average age of those who have committed this type of crime, and therefore been placed in the community, is less than 15 years. These are therefore children who struggle to recognize the negative value of the actions they have performed within the family context which is more often than not conflictual, often highly ambivalent".
The profile of minors who use violence against their family members is traced Maria Carla Gatto, president of the Juvenile Court of Milan, spoke at the digital meeting 'The mental health of adolescents: intercepting, preventing and caring in the Covid-19 emergency', promoted last June 11th by the Francesca Rava Foundation, with the patronage of Fofi (Federation of Italian pharmacist orders) and Federfarma.
"We are therefore faced with a new phenomenon - states Gatto to the Dire Agency - which deserves to be explored in greater depth because violent acts are a consequence of the entire adult system, understood as a family system and in general as a social system. While once upon a time aggregation also had a territorial connotation, for example children gathered in neighborhoods and in this way the institutions had the possibility of controlling the phenomena - recalls the juvenile justice expert - today digital and social communication allows young people to join together to commit crimes even without ever having seen each other and without belonging to the same territory. In the absence of a different thought, the only reason for aggregation is to act together with violence. The world of institutions and society must organize themselves and learn to move with the same speed as children to stem and prevent the phenomenon, because - warns Gatto - we are faced with the explosion of a phenomenon which, beyond the contingent situation, finds its roots in the lack of an educational and healthcare plan for mental health aimed at identifying early signs of psychological and behavioral disorders in children".
Gatto is clear: "We must move promptly to identify the early signs of this child distress. The whole community, including the pharmacies which are an important presence in the local network, must not be afraid to see and must know what to do after having seen. This is why we need to do training and research, to understand the phenomenon even in its hidden manifestations."
Violence involving minors has many faces, as he recalls Lisa Di Berardino, deputy commissioner of the postal police and
of communications in Milan, which lists some data relating to crimes committed in the virtual world. "Statistically, from the
From 2019 to 2020, there was a 77% increase in treated cases of victimization of minors, therefore child pornography, cyberbullying, sexting, solicitation. This - clarifies the deputy commissioner - means that we have gone from 2,379 to 4,200 cases. Just as there was a significant increase, equal to 132% of cases treated, of photographic and video child pornography material produced and posted online by the minors themselves. A trend also confirmed in the first 4 months of 2021, with a 96% increase in complaints".
Another relevant element is the lowering of the age of the minors involved: "In 2020-2021 we have already recorded cases
in the age group 0-9 years, a group totally absent from our surveys in 2019". Also in this case, recalls Di
Berardino, it is the world of adults that must provide children with the tools, practical but also ethical and moral, to face the
both real and virtual life, "to distinguish good from evil, to be able to recognize when one has made a mistake. Parents and agencies
educational institutions must monitor and at the same time keep up with young people in terms of digitalisation who - concludes the deputy commissioner with a positive thought - have the ability to understand, they know what is needed. We must reach out to them and never give up."
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The COMIP association “CHILDREN OF MENTALLY ILL PARENTS – Social Promotion Association”, the first in Italy created by and for the children of parents who suffer from a mental disorder, elto Foundation By Liegro, as Italian partners dthe European project “Share4Carers”, organizeno The Webinars "Children of parents with mental health problems: recommendations from European young carers and good practices for prevention and support" – “Children of parents with mental health problems: recommendations from young European caregivers and good practices for prevention and support” to be held on the Zoom platform (https://us02web.zoom.us/j/84511243676) The June 30, 2021 from 3.00pm toand 16.20.
The online seminar aims to be a precious opportunity for exchange and reflection onthe problems, but also the potential, of many children, adolescents, young adults and their families, who are also due to the taboo on this topic at high risk of social exclusion and suffering,in the absence of adequate prevention and a support network.
The project Share4Carers was born with the intention of sharing good practices aimed at children of parents with mental health problems with the aim of reducing risk factors and promoting those protective factors that are the basis of resilience and harmonious development.
Ccallndo gathering experts from the academic and clinical world and from associations in Belgium, Greece, Italy and Turkey, but also from other European countries, the project has the purpose Of supply to professionals, teachers, institutions and civil society the tools necessary to promote the psycho-education and raise awareness on the social impact of being young caregiversof parents who experience psychological distress.
The long-term goal of the project is to build recommendations that help promote fighting mental health stigma, resilience, social inclusion and positive development in children of parents with a mental disorder together with support for their families to promote change concrete in policies at national and EU level.
The webinar, in English, will last about an hour and twenty minutes and will be divided into two sections: the first during which the results of an investigation will be presented that hto involved i young caregivers of 5 European countries; the second in which they will be presentedate good practices and interventions from France, Italy, Great Britain and other cutting-edge entities in this sector. Also starring are children, experts by experience and activists.
