THEn Italy, mental health is still considered a luxury which you can do without: the psychologist bonus about which so much had been talked about close to approval from the Budget Law (which has donated funds to everyone, there is even the mosquito nets bonus) it did not find a place there and not even in the Sostegni Ter decree.
Psychologist bonus: the reasons for the “no”
Yet, the measure was considered by many to be a step forward, the recognition of mental well-being as a right of all citizens, even those who cannot turn to professionals who work in private. The need for concrete help The proposal, which arose from a bipartisan agreement in the Senate, provided for the allocation of 50 million euros, which was blocked by the Ministry of Finance. “Behind the economic question, perhaps someone thought that the bonus could have generated conflicts between individuals and the National Health Service” explains David Lazzari, President of the National Council of the Order of Psychologists (Cnop). “It is clear that the offer of psychological therapies of the NHS should be strengthened, but facilitating access to treatment in the private sphere is not to the detriment of the public, neither from an economic nor an organizational point of view. Restructuring public services requires a long time and important investments, the bonus would have been an immediate response. On the other hand, no answer was given, while we are in an emergency situation ».
The data speak for themselves: according to a study published in the Journal of Affective Disorders and conducted by researchers from the Higher Institute of Health, the University of Genoa, Pavia, and the Mario Negri Institute, more than 40 percent of Italians saw worsening during the lockdown of 2020 symptoms of anxiety and depression. Similar data has emerged from research around the world.
A cultural turning point
Allocating funds for mental health, however, was not just going to be patching this state of emergency. “If the government had set up a fund to allow citizens to take care of their mental well-being, the provision would have had a cultural value. The importance of this aspect of health would have been concretely sanctioned: although today we talk about it a lot, even diseases such as depression or anxiety are still experienced by many who suffer from them with shame or judged as forms of weakness. More needs to be done in this sense because the economy is also helped by investing in intangible assets like this. Life itself is immaterial: advertisers know that when they promote a product, they focus on the emotion it gives. People know what makes them happy and politics should listen to them if social evolution is to be achieved, ”adds Lazzari.
The no to the bonus also prompted a “bottom-up” mobilization: on Change.org a petition to reinstate him, addressed to the Government is now at the threshold of 300 thousand signaturessupported by a vehement social protest.
The ghost of the basic psychologist
In Italy, the right to psychiatric treatment is established by law. The Dpcm of 12 January 2017 included mental health among the Lea, that is the essential levels of assistance, but in fact in our country for a large slice of the population it is not possible to use this service.
«On paper, anyone who needs psychological support can contact the ASL without having to book the service. But in fact in public structures the few specialists present follow very serious situations, so if you do not fall into this case, you are not easily taken in charge. If you get the appointment, then precisely due to the scarcity of professional resources available, you have access to a limited series of sessions, or it may happen that the meetings are deferred over time, one a month when it would perhaps be appropriate to fix one a week . In this way the therapy loses its effectiveness »continues Lazzari.
“Today the public service, in fact, no longer does psychotherapy because it is always in an emergencyto. There is a lack of specialists in the places of first access such as general practitioners and consultants, most of them deal with addictions and / or child neuropsychiatry, second level services intended for the most problematic cases. We need those who deal with everyday life, proximity psychology »concludes David Lazzari.
Psychotherapy at controlled prices
Many are mobilizing to make up for this structural deficiency. Not to replace the public service, but to remedy some of its shortcomings. On Dimmy (dimmy.it), for example, you can talk to a specialist at lower prices than those of a single session (which usually goes from 80 euros upwards), but also give a suspended session, following the example of Neapolitan coffee , to someone who can’t afford it.
Prices also controlled on Open Psychotherapy (psychotherapy-aperta.it), a platform created three and a half years ago by Luigi D’Elia, psychologist and psychotherapist, who today counts on a base of 1500 professionals scattered throughout Italy. Just enter the address and choose the type of intervention to get the therapist’s name and make an appointment. The site was born thanks to crowdfunding, it was above all the patients who contributed, and today the rates are about one third of those on the market. “It is not the solution to the problem. We try to make up for the inefficiency of the public sector, which pays for the fact that it is underfundedExplains D’Elia. And he concludes: «The problem is that when one leaves the training period, a specialist expects to work privately, according to an eighty-year-old scheme whereby the profession retains an elitist dimension. Training, on the other hand, should be invested with a broader, social mandate: 1500 specialists is a small number compared to 35 – 40 thousand Italian colleagues, an asset not used because many in the end work little. This is what led us to a short circuit that we dream of reversing, we need to raise awareness of carrying out a public function and we need a system that makes our skills accessible to all. Today something is starting to move but we are an invisible category, when it comes to problems that concern us we are not even questioned “.
In short, will the “scooter lobby” continue to be worth more than mental health?
Psychologist bonus: the regions leading the way
While waiting for the situation to clear up, some Regions have moved independently. The first to realize the intentions was Campania, with the law n. 35 of 3 August 2020, resulting from the Covid-19 emergency. Rejected by the Presidency of the Council of Ministers, it reached the Constitutional Court, which gave the green light last December to the basic psychologist: freelancers will be able to work in the ASL to integrate general practitioners and pediatricians of free choice . Still in drafts, however, other initiatives. Approved the free basic psychologist the Regional Council of the Lombardy, while the President of Lazio Zingaretti announced a 2.5 million euro fund to be allocated to mental health; the funds will be disbursed through a voucher to be used in public facilities. The CGIL, however, objected that in the Region there is a lack of professionals in the sector and that it would be necessary to leave the logic of the bonus to really enhance the public service. It is clear to everyone that an intervention on the gears of the system is necessary, but it would not spoil a common front.
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