TY - JOUR
T1 - Pathways to mental health care in Italy
T2 - Results from a multicenter study
AU - Volpe, Umberto
AU - Fiorillo, Andrea
AU - Luciano, Mario
AU - Del Vecchio, Valeria
AU - Palumbo, Claudia
AU - Calò, Salvatore
AU - Piras, Sara
AU - Signorelli, Maria
AU - Filippo, Dario
AU - Piselli, Massimiliano
AU - De Fazio, Pasquale
AU - Gotelli, Simona
AU - Bardicchia, Francesco
AU - Cerveri, Giancarlo
AU - Ferrari, Silvia
AU - Mulè, Alice
AU - Ribolsi, Michele
AU - Sampogna, Gaia
AU - De Rosa, Corrado
AU - Sartorius, Norman
PY - 2014
Y1 - 2014
N2 - Background and aims: In Italy, the reform of the mental health system in 1978 should have drastically changed the provision of care and pathways of patients seeking to obtain it. The aim of this article is to examine the current pathways to psychiatric care in Italy. Methods: We used a method developed in the World Health Organization international collaborative studies to investigate pathways to care in 15 Italian mental health centers. We recruited 420 patients with a psychiatric illness and explored the care pathways they took to reach to psychiatric services and the delays from the onset of illness to reaching psychiatric care. Results: The majority of patients (33.8%) had direct access to mental health care, whereas the others arrived to a specialist in psychiatry through general hospitals (20.3%), general practitioners (33.0%) or private practitioners (9.8%). The main diagnosis for referral was neurotic disorder (36.6%), followed by affective disorder (35.4%) and psychotic disorder (11.5%). The delay from onset of illness to psychiatric care was greater for patients with psychotic disorders than for those with affective and neurotic disorders. The most frequently prescribed treatments were pharmacotherapy (56%), psychological support (8%), and psychotherapy (7.0%); 15% of the patients received no treatment. Conclusions: Our multicenter study shows that although general practitioners and hospital doctors are still the main referral point for mental health care, a greater proportion of patients are first seen in private settings or directly reach mental health centers, compared to previous surveys conducted in Italy. However, a stronger collaboration of psychiatrists with general practitioners and psychologists is still needed.
AB - Background and aims: In Italy, the reform of the mental health system in 1978 should have drastically changed the provision of care and pathways of patients seeking to obtain it. The aim of this article is to examine the current pathways to psychiatric care in Italy. Methods: We used a method developed in the World Health Organization international collaborative studies to investigate pathways to care in 15 Italian mental health centers. We recruited 420 patients with a psychiatric illness and explored the care pathways they took to reach to psychiatric services and the delays from the onset of illness to reaching psychiatric care. Results: The majority of patients (33.8%) had direct access to mental health care, whereas the others arrived to a specialist in psychiatry through general hospitals (20.3%), general practitioners (33.0%) or private practitioners (9.8%). The main diagnosis for referral was neurotic disorder (36.6%), followed by affective disorder (35.4%) and psychotic disorder (11.5%). The delay from onset of illness to psychiatric care was greater for patients with psychotic disorders than for those with affective and neurotic disorders. The most frequently prescribed treatments were pharmacotherapy (56%), psychological support (8%), and psychotherapy (7.0%); 15% of the patients received no treatment. Conclusions: Our multicenter study shows that although general practitioners and hospital doctors are still the main referral point for mental health care, a greater proportion of patients are first seen in private settings or directly reach mental health centers, compared to previous surveys conducted in Italy. However, a stronger collaboration of psychiatrists with general practitioners and psychologists is still needed.
KW - Community mental health service
KW - General practitioners
KW - Mental health systems
KW - Pathways to care
KW - Primary care
KW - Psychiatric care in Italy
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U2 - 10.1177/0020764013501648
DO - 10.1177/0020764013501648
M3 - Article
C2 - 24051155
AN - SCOPUS:84905645521
VL - 60
SP - 508
EP - 513
JO - International Journal of Social Psychiatry
JF - International Journal of Social Psychiatry
SN - 0020-7640
IS - 5
ER -