Mental Health in the Coronavirus Disease 2019 Emergency—The Italian Response | Infectious Diseases | JAMA Psychiatry | JAMA Network
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    1 Comment for this article
    Emergency Psychology
    Giovanna Calabrese, M.D. PhD. Psychiatry | Active member at Società Italiana Psicologia Emergenza
    I noticed that the authors did not mention the activity of the Società Italiana Psicologia dell' Emergenza (Italian Society of Emergency Psychology) that in collaboration with Protezione Civile provided an important support, on voluntary basis, for the general population subjected to quarantine, among wich there were also patients of the Mental Health Services closed because of the Emergency and many health care providers experiencing acute stress disorders.
    CONFLICT OF INTEREST: None Reported
    Special Communication
    April 30, 2020

    Mental Health in the Coronavirus Disease 2019 Emergency—The Italian Response

    Author Affiliations
    • 1Unità Operativa di Psichiatria Epidemiologica e Valutativa, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
    • 2Department of Mental Health and Addiction, ASST Lodi, Lodi, Italy
    • 3Department of Mental Health and Addiction, ASST Monza, Monza, Italy
    • 4Department of Mental Health and Addiction, ASST Bergamo Ovest, Treviglio, Italy
    • 5Department of Mental Health and Addiction, ASST Cremona, Cremona, Italy
    • 6Department of Mental Health and Addiction, AUSL di Modena, Modena, Italy
    • 7Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
    • 8Department of Mental Health and Addiction, ASST Brescia, Brescia, Italy
    • 9Psychiatric Clinic, University of Brescia, Brescia, Italy
    • 10Psychiatric Clinic, University of Milan Bicocca, Monza, Italy
    JAMA Psychiatry. 2020;77(9):974-976. doi:10.1001/jamapsychiatry.2020.1276
    Abstract

    Importance  This article briefly reports the experience of mental health services and the lessons learned during the coronavirus disease 2019 (COVID-19) crisis. In particular, this report offers opportunities to build on experience gained in managing the COVID-19 emergency in the Departments of Mental Health and Addiction (DMHAs) in Lombardy, the wealthiest Italian region, which has approximately 10 million inhabitants.

    Observations  Italy has a National Mental Health System divided into 134 DMHAs, 27 of which are in Lombardy. In the 4 weeks after the epidemic started, important changes occurred in the management of DMHAs in Lombardy. Many challenges have occurred in the management of health services. In many hospitals, entire wards, including some psychiatric wards, have been reorganized to admit patients with COVID-19, and many physicians and nurses have been diverted to wards managing patients with COVID-19. Most day facilities for patients with psychiatric needs have been temporarily closed, whereas in residential facilities, patients who usually are free to come and go during the day have had to be confined in the facilities with very limited or no leave. These changes have produced considerable stresses on people with severe mental disorders. Many outpatient clinics have limited appointments to those with the most urgent cases, and home visits, a common practice in most DMHAs, have been drastically reduced with potentially detrimental consequences for patients’ well-being. Another potential detrimental consequence of being forced to stay at home has been an increase in the hours spent face to face with families with high amounts of conflict.

    Conclusions and Relevance  Departments of Mental Health need to be equipped with appropriate e-health technologies and procedures to cope with situations such as the COVID-19 pandemic. Additionally, interventions are needed to mitigate the potentially harmful consequences of quarantine. Departments of Mental Health should be able to assume a leadership position in the psychosocial management of disasterlike situations, and this requires the acquisition of new skills, notably how to correctly inform the population about risk, train and disseminate effective preventive and management procedures for disasters, support health personnel and rescuers, and support those experiencing bereavement.

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