In the first nine months of 2021 the number of hospitalizations per psychiatric disorders of children and adolescents in Italian hospitals exceeded the 2019 total. Impulse loss, self-harm, eating disorders are among the main diagnoses with the greatest increase in 2021, which also confirms the growing trend globally in Italy.
It’s the SINPIA alarm – Italian Society of Childhood and Adolescent Neuropsychiatry launched at the end of the 29th National Congress of the Society held between 3 and 6 November in the presence of over 500 child neuropsychiatrists and more than 80 national and international speakers and moderators.
“We are facing a critical situation – explains Antonella Costantino, president of SINPIA, Italian Society of Childhood and Adolescent Neuropsychiatry – it is necessary to act immediately to promote mental well-being, to minimize the consequences of the Pandemic on the mental health of the younger generation, to identify the warning signs as early as possible and to be able to offer rapid and appropriate responses to the need. In the last 10 years we have seen a doubling of patients followed in the services of Child and Adolescent Neuropsychiatry in the face of continuously diminishing resources, in no other area of medicine has there been such a significant increase. And today, due to the worsening of the pre-existing criticalities of the pandemic and the new clinical problems that are emerging, the asymmetry between the need and the ability to respond has become dramatic “.
According to the preliminary data of the broader international study onimpact of the pandemic on the mental and physical health of children and adolescents presented at the SINPIA Congress, on mental well-being of minors decreased by more than 10% globally, with the doubling of children below the threshold of discomfort and with an increase in anger, boredom, difficulty concentrating, a sense of loneliness and helplessness, stress, sleep disturbances.
They were even more serious the effects of the pandemic for those who already presented situations of associated vulnerability or fragility, such as pre-existing neuropsychic disorders, situations of social fragility and economic difficulties, overcrowding, bereavement, migration, inability to access or insufficient electronic tools to connect to the DAD and other services. For this group of minors the worsening was almost double compared to healthy peers, estimated at more than 25%.
A certified deterioration in Italy since hospitalization boom in 2021, after in 2020 due to the restrictions for the Pandemic the number of accesses to the emergency room and hospital had plummeted 25%, with fluctuations between the 10 and the 30% in the different regions.
To date, however, the situation appears critical and SINPIA experts speak of a real one return wave, with more than85% of hospitalizations in the ward occurred in urgency, for patients with increasingly complex clinical pictures, worsened by the delay in accessing services following the pandemic. In some regions, 1 in 4 minors are admitted to an adult psychiatry ward due to a lack of neuropsychiatric beds.
Among the further criticalities highlighted, acute psychiatric imbalances in children welcomed in educational and therapeutic residential structures and in unaccompanied foreign minors, due to the intersection between vulnerability and basic post-traumatic aspects and unfortunately often too rigid management by the structures of restrictions, with still significant limitations on activities and contacts with families and with the outside world.
In 2020, at least 25% of patients had difficulties in accessing local services. Many services of Childhood and Adolescent Neuropsychiatry (NPIA) they have not been able to guarantee continuity of care during the Pandemic, through telemedicine activities due to the lack of technological equipment or the non-authorization by individual companies. The introduction of integrated treatment pathways between on-site activities and telemedicine activities, particularly advantageous in some neurodevelopmental disorders, is still very problematic.
“The Pandemic and the indispensable strategies for its containment – conclude Antonella Costantino – not only have they increased the stress and overload on children and young people and their families, in particular on the most vulnerable situations, but they have made the tamponade strategies that were previously implemented, both by individuals and by the community, no longer practicable . It is evident how the type and quality of the responses implemented in this very complex year and in those to come will determine very significant differences in the mental health of future adults in our country.”.