gparents and teenage children. “We didn’t notice.” The parents of the three girls protagonists of thin lives, The documentary about anorexia aired on Discovery+, are affectionate, attentive, knowledgeable. But all the preparation ellove wasn’t enough to make them understand that something was wrong, that behind the fixation on the scale and the look in the mirror there wasn’t a generic dissatisfaction with oneself but a deep malaise. They just had time to take their daughters to the emergency room. Today they are followed by the Bambin Gesù in Rome, under control. The adults in a self-help group are trying to figure out what happened.
Teenagers and self-destruction
Adolescence has always been a tiring phase of self-acceptance. Problems with food, social isolation, a general depression are nothing new. But another thing is what is happening in recent years and that the pandemic has exacerbated: between 2020 and 2022, access by minors to the emergency room for attempted suicide and self-harm increased alarminglyhospitalizations for eating disorders tripled between 2019 and 2021. At the Gaslini children’s hospital in Genoa, for example, hospitalizations in Neuropsychiatry for acute psychiatric disorders have quadrupled compared to pre-Covid. Parents don’t see that their children are sick. Then, when they see, they freeze.
The signals to intercept
But how to understand if there is something more than the exasperated bad mood of a teenager? Alessandro Albizzati, director of the child neuropsychiatrist at the Local Health Authority of San Paolo and Carlo in Milan, advises: «The alarm must go off when the social withdrawal or mood change stabilizes and they start invading the life of the family. If a girl goes around in August with a long-sleeved shirt, you need to check if it’s pure non-conformity or something more serious, such as cuts or self-harm. Likewise if she becomes tyrannical over her body, something is wrong.’
Adds Elisa Maria Fazzi, president of the Italian Society of Childhood and Adolescent Neuropsychiatry and professor of Neuropsychiatry at the University of Brescia: «It is not so much the specificity of the single symptom that counts, but the repetition, duration and intensity. The accentuation of isolation, the reduction of contacts, excessive physical activity, excessive concern with weight are sporadic symptoms in many adolescents. But if they affect the quality of life, we need to intervene ».
The problem is that many parents think that this is a passing phase. It is not a question of underestimating, but of failing to evaluate. “They don’t understand how their children, who have everything, can suffer. They struggle to accept it, they don’t see the reasons,” adds Professor Fazzi. «A child’s pain is frightening, especially for an adult who thinks he has done everything possible to offer serenity. I would add another theme: the stigma of mental illness. Parents reject the idea. This absolutely does not mean blaming the fathers and mothers, who are in great suffering”.
Difficult relationships with adults and peers
However, communication between generations remains difficult. According to a research by ItalyAdoptionswho submitted a questionnaire to the adolescents from Milan and its province, 30 percent of the sample declares that they do not confide in anyone, 16 to have absent or difficult relationships with family members, 18 also with peers outside the school walls. But the most disturbing data is that 34 percent of boys and girls cannot imagine their future.
Silence can be detrimental. Yet something can be done to prevent or when the signs are at the beginning. “Parents should change their attitude” is the opinion of Laura Peltonen, who manages the Coaching desk for parents and adolescents on iodonna.it (write to [email protected]). «I always recommend giving hope. We adults pass on our pessimism to kids and they feel the same, even if they don’t seem to listen to us. We should shift the focus from school grades – many dads and moms only think about that – to emotions. There is always some passion, you have to accompany teenagers to explore it. Don’t just investigate how the audit went. Better to ask: how are you? And maybe try to get them involved in topics that interest everyone, such as the environment».
First step: the pediatrician of reference
However, when the situation becomes more critical, it cannot be postponed. The first step must be to involve the pediatrician of free choice, or the family doctor. “It must be him, or she, who makes an assessment and liaises with the local services,” Fazzi points out. Assuming that pediatricians have the skills, even if “today there is a lot of training,” says Albizzati. «We talk less about tonsillitis and more about mental health in the developmental age».
Gian Vincenzo Zuccotti, Dean of Medicine in Milan and director of Pediatrics at the Buzzi hospital agrees. “It is true that mental health is not among the most frequently addressed educational topics. But we are doing a great job of raising awareness and prevention among doctors and parents, also because it is difficult to reach teenagers directly. The fact remains, however, that there are few places to be followed by the public».
Here come the bad news. Why it is right to hope that the general practitioner will network and ask for an appointment with the clinic for teenagers, but we already know that the wait will be long. “Territorial medicine is in great pain and everyone ends up turning to the emergency room,” explains Albizzati. There are 8 beds in child neuropsychiatry in the metropolitan city of Milan; in Brescia 16, but they are the reference point for all of eastern Lombardy. Professor Fazzi gives us the numbers at a national level: «Throughout Italy there are 395 beds, compared to over 4000 in Pediatrics and another 4000 in Psychiatry, the gap is enormous. In five Regions there are none at all ». As far as eating disorders are concerned, you can consult the specific website of the Higher Institute of Health food disturbance platform.iss.it with the map of the territorial centers.
Who to contact: toll-free numbers, switchboards, communities
Something is moving. In Milan, the Municipality has activated Welcome ME, a service for 14-18 year olds with a toll-free number (800 666 315) and a mobile phone (335.1251973). From April to December 2022 there were 1762 contacts. At the first phone call, an assessment of the need is made and a decision is made whether to refer to specialists. So far, 185 minors have been taken directly into care (at the request of their parents), 60 per cent girls, on average sixteen years old. The problems that emerged: social withdrawal, difficulties in peer relationships.
There Sole Terre Foundation has put 90 psychologists online throughout the country who answer a switchboard (3357711805; psychologistisoleterre.org) and offer free consultation, remotely or face-to-face. Since the service started, 229 teenagers have been taken into care.
The Abel group launched the Nine and 3/4 program dedicated to hikikomori, young people who retire at home. But it is the young people themselves who carry out the most interesting projects.
Beatrice De Luca, a university student from Turin, created the community with five friends All knottedwith an Instagram page dedicated to mental health. «We left in November 2021, when we were in high school, after the suicide of one of our classmates. We realized that no one had helped us, not even the school » she explains. «Today we have service columns that we write in collaboration with some psychologistsfor example we explain the false myths about suicide, or what depression is. We collect testimonials like that of Giorgia, 17, who suffers from anorexia and sent us a video where she talks about herself. We indicate the structures to which you can turn, free or at affordable prices. Communicating with adults is difficult» concludes Beatrice. “A peer talk can have multiple positive outcomes.”
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