Current State and Future Prospects of Psychological Therapies in Italy
Paolo Michielin, Ezio Sanavio
The Consensus Conference on Psychological Therapies for Anxiety and Depression has concluded its work and published the final document. Clinicians, researchers, public health specialists and users met to formulate questions about efficacy, effectiveness, appropriateness of treatment and access to care for anxiety and depression, and to consider the role of psychological therapies. Four expert groups collected information on the role and efficacy of psychological therapies in common mental disorders (CMDs), guidelines, patient assessment according to levels of symptom severity matched to corresponding levels of treatment intensity, knowledge and skills to be provided by university psychological and medical courses, and on initiatives to raise awareness among potential users and decision-makers. On the basis of the experts' report, a jury chaired by Silvio Garattini formulated a set of recommendations: some models of psychological therapy are supported by research that demonstrates an efficacy at least equal to the drugs used in CMDs; these therapies are underrepresented in the Italian public health system, leading many people to resort to the private sector, resulting in unacceptable wealth discrimination; the difficulty of accessing psychological care often involves the use of pharmacological therapies in cases where they are not indicated, and very high social costs. Psychological treatments for depression and anxiety play a key role in the overall list of interventions aimed at reducing distress and impairment in psychosocial functioning of people with CMDs. Much needs to be done in Italy to improve timely access to these treatments, to ensure they are delivered correctly, and to guarantee the accountability of the healthcare professionals who provide them. The UK experience, Improving Access to Psychological Therapies, indicates compatibility with a containment of health care costs. To update recommendations over time and monitor the evolution, the Consensus has not dissolved, but has set up a permanent committee, some working groups and four thematic committees: (a) Editorial; (b) Training and updating of professionals; (c) Sensitization and monitoring; (d) Childhood and adolescence, whose work is illustrated in the article.
Keywords
Common mental health disorders, Efficacy of psychological therapies, Guidelines, Treatment accessibility, Health equity.
