Anxiety and depression are among the heaviest consequences of the pandemic. Over 40% of Italians reported a worsening of anxious and depressive symptoms during last year's national lockdown, with a reduction in quality of life more than 60% of subjects and repercussions on the sleep-wake rhythm more than 30%, as reported by the Ansa Agency.
This is what emerges from the first study conducted in Italy on a representative sample of the adult population, the result of the work of psychiatrists, public health experts and biostatisticians from theHigher Institute of Health, from the University of Genoa and Pavia, of theMario Negri Institute of Pharmacological Research, presented last June 21st.
The study, published in Journal of Affective Disorders, is based "on a representative sample of over 6,000 subjects that we are following over time - specifies Silvano Gallus, researcher at Mario Negri and coordinator of the research consortium - which will allow us to analyze how the lifestyles and mental health of Italians have changed and are changing over time, following the restrictions imposed to control the Covid-19 pandemic".
Women are more vulnerable: approximately half of Italian women reported a worsening of their mental well-being with a risk of worsening depression and symptoms of impaired sleep quality, respectively 32% and 63% greater than men.
"The data in our possession are very solid and speak clearly - comments Andrea Amerio, psychiatric researcher at the University of Genoa and first author of the study - The use of psychotropic drugs, mainly anxiolytics, increased by 20% compared to the pre-lockdown period and all mental health indicators have worsened."
"The analyzes already conducted - states Roberta Pacifici of the Istituto Superiore di Sanità - have measured how the distribution of some behavioral risk factors such as smoking, gambling and other addictions has been influenced by the emergency context that we have experienced and how it is essential to intervene with targeted primary prevention actions".
On the occasion of World Refugee Day, the United Nations Children's Fund (UNICEF) and the National Institute for the promotion of the health of migrant populations and the fight against diseases of poverty (INMP) signed a memorandum of understanding For strengthen the health protection of minors, women and families with a migratory background.
The agreement between Unicef and INMP aims to:
Refugee and migrant children and adolescents and their families are often at increased health risks and face a variety of barriers to accessing quality healthcare. Many also experience severe emotional difficulties due to the trauma of travel and, many times, abuse and exploitation, including sexual and gender-based violence. The global COVID-19 pandemic has also further exacerbated these challenges.
It is necessary "ensure that their right to health is guaranteed - said Anna Riatti, UNICEF coordinator - also giving them access to quality information and services to face their journey in the safest way possible. The question becomes even more relevant if we consider the effects that the pandemic has on mental health and on the risk of gender violence".
The agreement therefore has as its objective "fair access to health by people highly at risk of social exclusion, with possible serious consequences on their health but also with a negative impact on the entire society - as explained by the INMP general director, Concetta Mirisola - When it comes to young people, in particular, the consequences are perpetuated over time, with incalculable economic but also, and above all, social costs., and this is not acceptable."
Di Liegro Foundation: we support and give dignity to people exposed to loneliness and abandonment.
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Research is underway on the mental health of minors in the time of Covid-19 promoted by theGuarantor authority for children and adolescents in collaboration with the Higher Institute of Health and the Ministry of Education. It's about the first scientific initiative on a national scale lasting three years with three intermediate steps which aims to offer an exhaustive and representative picture of the situation.
A sample epidemiological study is planned which will involve up to 7,500 minors divided into three age groups: 6-10, 11-13 and 14-18 years. An adequate representation of rural and urban schools in Lombardy, Emilia Romagna, Tuscany, Campania and Sicily will be guaranteed. The scientific committee of the project took office this morning. The Ministry of Education is also involved in the control room.
The will be collected good practices tested for raising awareness among parents and the population as well as strategies for promoting mental health in schools. The final report will include the recommendations of the Guarantor Authority to the Government and other institutions to provide a response to a problem that presents worrying characteristics.
“They have arrived numerous warning signs regarding cases of discomfort, self-harm, unhealthy eating disorders, alcohol or drug addictions among minors, often coming from some of the main Italian child neuropsychiatry departments, which require in-depth analysis. This project aims to understand in a scientific way how widespread and profound the phenomenon is and to understand in general what can be done to deal with it effectively" observes the Authority for Children and Adolescents Carla Garlatti.
The Authority promotes the implementation of New York Convention and other international instruments regarding the promotion and protection of the rights of children and adolescents, the full application of the European and national legislation in force regarding the promotion of the protection of children and adolescents, as well as the rights of minors to be welcomed and educated as a priority in their own family and, if necessary, in another supportive or substitute family environment. It is a monocratic body, endowed with autonomous powers of organization and administrative independence and without constraints of hierarchical subordination.
From the website of the Authority for Children and Adolescents
"Every year there are approximately 650,000 emergency room visits for psychiatric reasons. It is clear that it would be impossible to imagine an equivalent number of people to be subjected to strict supervision for possible violent behaviour, but we certainly have to ask ourselves about the connections that may exist between this first health intervention unit and the paths activated subsequently". As reported by the Dire Agency, he is the one who supports him Fabrizio Starace, president of the Italian Society of Psychiatric Epidemiology (Siep), who spoke on Radio24 in recent days to reflect on the condition of mental health in Italy. A reflection that is inspired by the triple murder that occurred in Ardea last Sunday, in which two children and an elderly man were victims of gunshots fired by a 34-year-old with mental problems.
"The territorial inequalities in our country are very marked and even intolerable - added Starace - especially when we consider that psychiatric assistance is not like a surgical operation which a person can benefit from by moving from one region to another and going to a center of excellence. It is assistance that is based in the reference community, aimed at reintegration and re-inclusion".
The problem is "a misunderstood perception of psychiatry which - President Siep further explained - continues to be considered in terms of performance, i.e. of outpatient visits, elicitation of symptoms and possible administration of a psychotropic drug. But this is not the community mental health foreseen by the law, the only useful tool to accompany and support people in difficulty but also to prevent extreme conditions and behavioral exacerbations". Suffice it to say that "even after compulsory health treatment (TSO) there is no continuity of care - added Starace - only the 30% of people who receive a TSO is seen in the 14 days following discharge from hospital. Probably due to problems of equipment and organization in the various territories".
A black and white photograph of Italian mental health taken by Starace. But that could be colored with the help of the Recovery Fund. "If we jumped forward 6-7 years and we were already in the conditions foreseen by the National recovery and resilience plan, with community homes and centers where groups of general practitioners alternate with groups of continuity of care doctors, having the possibility of intercepting the uncomfortable conditions themselves and giving continuity to the treatment - he stated - then evidently the facts of Ardea would have taken on other characteristics".
What tools do you need to put in place? "Those envisaged by the law, even before the Pnrr - added Starace - those which provide for Mental Health Centers spread throughout the territory, open 24 hours a day so as to be able to intercept these forms of distress at any time, with multidisciplinary teams projected towards the community, towards helping families. There is a systemic action to be implemented: we need to be present, proactive, leave clinics and hospitals, go to families' homes, encounter suffering and difficulties, thus avoiding extreme forms from manifesting".
In mental health"we don't need sophisticated technologies but we need human technology, competent and motivated people to carry out this work. One recovers from mental disorder - concludes President Siep - provided that action is taken early and appropriately, according to the treatment paths defined by the Ministry and with continuity over time".
The news on the Dire Agency website
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Finally free, finally normality. Yes, but how are we? And the question that arises in the return to sociality in recent weeks. At the moment there are 12 regions in the white zone, plus the autonomous province of Trento: in practice, over 40 million Italians, around two out of three citizens, live with anti-Covid restrictions reduced to a minimum. Yet it is not a given that everything is sunshine and roses.
As the psychiatrist explained to the Dire Agency Carlo Valitutti, we can see "a greater discomfort on the part of people compared to what happened after the first lockdown. Paradoxically, if on the one hand it is true that there is a desire for freedom, on the other hand many do not allow themselves to go so calmly into "the idea of starting to go to gyms or swimming pools again, for example. This is what you actually feel beyond what you might think when you see bars and restaurants open."
In short, more than one person is experiencing the much-desired return to life with some discomfort. According to Valitutti, a disconnect has been created between the need to protect health and the need to resume economic and work activities which has increased month after month, creating "confusion and a loss of critical sense in people".
In short, as longed for as they may be, the acceleration in the pace of vaccinations and the decline in infections (and deaths) have translated into a gap between the speed of external time and the need for slowness of internal time. "The speed of reopenings associated with a desire to return to normality has paradoxically created more confusion - added Valitutti - There are people who, instead of being happy with the restart, have now started to have doubts that perhaps they should have had before, in the midst of the pandemic According to a dynamic that must have occurred in the daily lives of many of us, people accustomed to using reason "have indulged in catastrophic assessments", encountering and posing obstacles to their normality.
But there is a solution, according to the psychiatrist: the exercise of one's critical sense. "It helps us think that we are living a
a necessary moment to safeguard ourselves and also necessary for the future - states Valitutti - Just as the idea that we are not omnipotent, that we cannot solve everything in a certain way but that we must respect ourselves and what surrounds us will be useful. The virus has pushed us back to our limit."
IncluPsy is a project funded with support from the European Commission which aims to promote the social inclusion of people living with mental disorders. There are 6 partners (coming from five different European countries) called to discuss and exchange their experiences in order to strengthen their capabilities and define good practices on the topic.
With Inclupsy we also want to increase the awareness and the involvement on the topic of a larger number of actors on the topic of social inclusion. In fact, according to the World Health Organization, one in four Europeans suffers from mental illnesses.
The report "Health at a Glance: Europe", created by the European Commission and the Organization for Economic Co-operation and Development, highlights how mental distress is one of the most urgent issues to be addressed and warns of economic and social consequences of the problem.
People with severe and persistent mental disorders generally suffer from a great sense of isolation, the loss of the ability to undertake initiatives and live in independent housing, hold a job and carry out normal daily activities.
These effects, combined with the stigmatization and, in certain cases, prolonged and repeated psychiatric hospitalizations themselves become a factor of social disintegration, leading people to lose their homes, wander the streets and be excluded.
In light of the links (as cause or consequence) between mental disorders and social exclusion, it is not surprising that inclusion is one of Europe's priorities. But What practices are implemented by Europe to promote the social inclusion of people living with mental disorders? This question is the underlying theme of the IncluPsy project.
Go to site by IncluPsy.
In the painting workshop, Gino uses colors confidently and without saving, almost exaggeratedly. Also sprinkling his face, hands and arms, which he uses as an extension of the sheet of paper.
Even his debut in the theater laboratory leaves us amazed. The choice of songs to perform during the rehearsals reflects the depth of his inner world: he interacts with the other participants and volunteers, as if they had always been artistic colleagues, and immediately establishes a particular relationship of trust with the director.
Gino is 38 years old. Two years ago, the operators of the Mental Health Centre, who follow him in his therapeutic-rehabilitative journey, advised him to attend the activities organized by the Di Liegro Foundation.
As mentioned, Gino immediately demonstrates a natural predisposition in using artistic language. Attentive, participate assiduously in everything that happens. His enthusiasm is uncontainable, contagious, so much so that it has become a catalyst for the group.
Gino is an affectionate person and his emotions are explosive: the kisses and hugs he gives when we meet make what he feels physical and tangible.
But the enthusiasm in being together has, on the flip side, a strong sense of loneliness. And when G. finds himself at home alone, bad mood and bad thoughts risk taking over.
The Di Liegro Foundation is a place of relationships and exchange for all the people who frequent it. Weekly meetings for laboratories, the training courses oi self-help groups they are fixed appointments; and for some participants the Foundation has become a point of reference, one of the few together with the health service and the family.
The suspension of in-person activities, with the closure of the headquarters during the pandemic for COVID-19, represented an important change for everyone: the lack of a meeting place was strong.
For some, more than others, the interruption of meetings and the impossibility of meeting in person and greeting each other with a kiss and a hug were an unexpected event, which shook a fragile balance.
This is exactly what happened to Gino.
Gino, more than his other course colleagues, was affected by the lockdown and the lack of those moments, developing acute manifestations of intolerance and depressive crises during the pandemic. And if in the first days the telephone contact allowed him to contain his discomfort to some extent, as the quarantine and isolation continued it was no longer sufficient.
Gino. he could no longer bear his anguish and called the Foundation workers saying that he was very ill and that he feared he wouldn't be able to make it. From now on. he was first admitted to an emergency service and then to a residential facility.
During the quarantine period, the Foundation's main objective was to remain in contact with its community of users, volunteers and families and to guarantee a listening and support service to citizens through the SOSS Mental Health Orientation and Social Support Service.
Since the first days of the pandemic we have established telephone appointments to monitor the effects that the emergency situation and imposed isolation was having on the most fragile people. Loneliness and the suspension of one routine, as well as more frequent attendance of mental health services, has been destabilizing for users and family members in particular.
The use of digital devices has been of great help to us in maintaining contact with participants, family members and volunteers, since we almost immediately moved the appointments of our activities onto digital platforms and most people, having a smartphone or a PC, participated in the appointments. When this was not possible, we maintained "analog" contact through telephone calls.
The online meetings gave the possibility, even if mediated by a screen, to see and talk to each other and to continue the laboratory activities.
This is what also happened with G., with whom we managed to stay in contact during all phases of his hospitalization, both in the hospital and in the residential facility, managing to involve him in the new digital appointments.
This new mode represented a challenge for all of us, a challenge which however was an opportunity for many to experiment with something new, acquiring familiarity with these means and new technological skills. Operators and volunteers have also reinvented themselves, using new ways to stay in touch and support users even remotely.
Today Gino is a little better. Every day he calls us to update us on his health and the question that always ends his phone calls is: “When do the laboratories resume? I miss them, I miss you!”.
For the Foundation, these months of the pandemic have been one stimulus to make people feel that the community we are part of continued to be present next to them and it showed us that, sometimes, a limit like online meetings can turn into an unexpected opportunity.
According to Istat's 2020 report on fair and sustainable well-being, mental well-being worsens among the elderly and among residents in Lombardy, Piedmont and Campania. The BES provides an annual analysis of the progress and critical issues of the dimensions of well-being in Italy. In the year of the pandemic, the analysis of the mental health index takes on particular importance.
The Institute of Statistics reports that the general change for the total population compared to 2019 is not significant, perhaps because in the early stages of the epidemic the evaluation of one's health conditions was influenced by the relativization of one's own psycho-physical state in comparison to that of other people in worse situations and by the important role played by the family context which made it possible to maintain an atmosphere of serenity in most families.
However, different trends emerge in subgroups of the population. The situation of people aged 75 and over worsens both among men and women; among men of this age it drops by 1 point (which becomes -2 points for residents in the North), among women the drop is also observed among those aged 65-74 (-1.7).
The conditions of greater isolation experienced during 2020 especially affected the mental health of single people in the 55-64 age group, even here especially in the North. Even among young women aged 20-24, however, the score dropped by more than 2 points compared to the previous year.
The mental health index worsens in Lombardy, Piedmont and Campania which present the lowest values together with Molise. Gender gaps are widening, with more unfavorable conditions for women (66 versus 71.1). Mental well-being conditions deteriorate with increasing age, with a difference of approximately 10 points between the scores of the youngest and oldest.
The positive evolution of life expectancy stops. The health chapter notes in particular that the positive evolution of life expectancy at birth between 2010 and 2019, despite evident geographical and gender inequalities, was severely slowed down by Covid-19 which canceled out, completely in the North and partially in other areas of the country, the expected gains in years of life accrued over the decade.
The Mental Health Index is a measure of psychological distress (psychological distress) obtained from the summary of the scores obtained by each interviewee over the age of 14 on the questions referring to the four main dimensions of mental health (anxiety, depression, loss of behavioral or emotional control and psychological well-being). The index varies between 0 and 100, with better psychological well-being conditions as the value of the index increases.
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If you are at least 18 years old and are the child of parents who live or have lived the experience of mental suffering, we would like to know and give voice to your experience.
By answering a completely anonymous questionnaire, you will be able to help us continue the project Share4Carers and to make this topic better known. Your answers, together with those of other sons and daughters from other European countries, will help us understand the situation in Europe and will be the starting point for producing recommendations for policymaker, institutions, professionals and others stakeholders.
If you would like to participate, click on this link:
and please leave your email address. In the next few weeks you will receive the questionnaire in your email inbox. To ensure you receive it, also check your Spam/Junk Email folder.
COMIP (Association for the Social Promotion of Children of Mentally Ill Parents) and the Don Luigi Di Liegro Foundation, together with partners from other European countries of Turkey, Belgium and Greece, are carrying out Share4Carers, an Erasmus+ Project for share good practices for supporting children of parents with mental health problems in Europe.
The ambition of the Share4Carers project is to produce recommendations that will contribute to promote resilience and positive outcomes in children of parents with mental disorders and in their families, accelerating the adoption of psychoeducation practices across Europe by involving patient and family organisations, professionals and caregiver in the development of good practices themselves.
Thank you for helping us raise awareness of the "Forgotten Children" and to do advocacy for prevention and support!
Find out more about the project
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Serious mental disorders that can compromise parenting ability. In the research conducted, children frequently report experiences of neglect and abuse, feelings of fear or danger due to the psychiatric symptoms of their parents for whom they are "forced" to become caregivers.
The data and research on this condition are fragmented and too often incomplete, but they provide a dramatic picture. In 2004 (Nicholson et al.) reported that the 67% of women and the 75% of men experiencing conditions of serious mental distress (including schizophrenia, bipolar disorders, severe depression) are parents.
Furthermore, the interaction between genetics and environment in combination with high exposure to emotional stress represents a risk factor for children (both minors and adults) to develop psychiatric problems in the future.
Hence the need to raise awareness and inform civil society on the topic and to focus on concrete tools to support the children of parents with mental health problems. The project therefore worked, thanks to the collaboration of partners from different countries (Belgium, Greece, Italy and Turkey), on sharing good practices on advocacy strategies and promoting a change in policies at national and EU level. The main recipients of the information and awareness actions, in addition to mental health professionals, were family caregivers: to orient them to the support services of mental health services and to promote the exchange of experiences and mutual help.
