Mental illness in Italy: the disease that dare not speak its name

The Basaglia law was supposed to close mental asylums and help patients through local communities. Forty-two years later, that support still doesn’t exist. Instead, people are treated with drugs behind closed doors. Lavinia Nocelli reports

During the first wave of the pandemic, the cities of southern Italy were not hit as hard as the rest of the country

(Lavinia Nocelli)

There have been 30 suicide cases this past summer,” says Massimo Mari, director of the district mental health department in Jesi, central Italy, as he runs his hand through his hair, his face marked by exhaustion. “There were 15 in just over two weeks, five of which were in the town of Filottrano. People are not being monitored by our network. We just managed to catch a few of them before it was too late. If I’m short of 19 nurses, 19 educators, 11 psychologists and seven psychiatrists, how am I supposed to work? These numbers are the bare minimum to handle emergencies, but ideally you would need…”

He stops. He is irritated by the situation. His gaze is clouded by the hopelessness of it all. Piles of papers and books tower on his desk, bearing witness to the hard work of the past few months. While his own requests for help seem to be ignored, calls for assistance continue to pour in from the community. Some cannot sleep at night, while others have crippling anxiety or are afraid that death is just around the corner. This is the shadow pandemic: that of mental illness.

Nearly 20 per cent of Italy’s population suffers from a mental disorder, and yet the care provided by the Italian health system barely covers 25 per cent of the psychological needs of the people as laid out by the “essential levels of care” – the services and benefits that the Italian national health service (SSN) is required to provide to all citizens. Meanwhile, the average national health expenditure on mental illness amounts to a mere 3.6 per cent of the available budget.