The Mental Health paradox, between increased demand and cutback of resources

Fabrizio Starace

Direttore, DSMDP AUSL Modena, Presidente, Società Italiana di Epidemiologia Psichiatrica

Italian Mental Health system has so far represented a positive anomaly in the international scenario of community psychiatry. With psychiatric hospitals closed since 1978 and forensic psychiatric hospitals dismissed since 2014, Italy has shown that a community alternative to large institutions is feasible and cost-effective. Strategies to support housing, job placement and social inclusion of people affected by mental illness put into practice the EU Fundamental Rights of citizenship and non-discrimination, contributing to fight stigma and to reduce the risk of hospital admission. As a matter of fact, Italy has one of the lowest number of acute beds among OECD countries and shows rates of compulsory admissions which are significantly lower of other western industrialized countries.

However, the ongoing economic crisis and the recent, additional cuts to public health financing, cast considerable doubts over the sustainability of the Italian mental health system. Paradoxically, this happens while the same economic crisis is exerting a heavy toll on community mental health, increasing the need of psychiatric care.

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