2.8. Mental disorders

In recent years, all the various international bodies have promoted and supported mental health policies as part of their broader public health framework, of which it constitutes an essential part.

Istat data for 2009 and 2010 indicates a “reported” prevalence of mental disorders (classified as “nervous disorders”) of approximately 4.3% for the total population, which rises to 9.8% for the over 65s. Generally speaking, women are at higher risk, almost double that of men.

The data published by the OSMED national monitoring centre shows that over the past decade (2000-2009), the consumption of antidepressants has undergone a mean annual increase of 15.6% with an increase from 16.2% DDD per thousand inhabitants to 34.7% in 2009.

The data provided in the “Annual report on hospital admissions – Hospital Discharge Sheet data for 2009” for ordinary hospital admissions for discipline 40 (Psychiatry) shows that considering the absolute number of admissions (120,880), the repeated admission rate in psychiatry (41,111) is one of the highest (34.0).

Lastly, according to the Istat survey on admissions for mental disorders, mandatory medical treatments (MMT) underwent a slight increase in the period 2005-2008, from 4.16% of all psychiatric patient discharges in 2005 to 4.55% in 2008. The same applies for sex-specific analysis, where the values are significantly higher for males. The age group most affected is the 25-44 years range, for both sexes.

The main priorities (see also the Protection of mental health paragraph) for the adult age are:

• the promotion of epidemiological research activities in the aetiology field;
• simplified access procedures favouring swift referral to allow early management of the more severe conditions, such as schizophrenia and bipolar disorder;
• the establishment within the Italian NHS of diagnostic, treatment and caregiving programmes based on evidence-based practices, particularly in the psychotherapy and rehabilitation sector;
• the inclusion in the essential levels of care of feasible caregiving programmes based on real needs.

For the developmental age:

• the implementation of programmes for the primary prevention of mental disorders and the promotion of mental health from infant and primary school age, involving the family;
• dealing with the topic of emergencies related to mental disorders during adolescence;
• favouring of interaction and coordination between infantile neuropsychiatry services, mental health departments and the general paediatric care network, supporting the development of continuity pathways between infantile neuropsychiatry and adult psychiatry services, thereby improving the skills of mental health departments and giving a greater value to their common areas of work;
• reviewing the essential levels of care in the mental health of the developmental age area.