First access to mental health services during COVID-19 pandemic: A multicenter study.

BACKGROUND: The impact of the COVID-19 pandemic on mental health is complex and affects a broad segment of the population. Several studies indicate that depressive, anxious and post-traumatic symptoms are common in people exposed to SARS-Cov2. METHODS: 458 subjects were recruited during their first consultation in outpatient psychiatric services between June 2020 and October 2021. Post-traumatic, depressive and anxious symptoms were assessed using the Impact of Event Scale-Revised (IES-R), the Beck Depression Inventory Scale-second edition (BDI-II), and  the Self Rating Anxiety Scale (SAS). A specific set of questions was developed, with the aim of evaluating socio-demographic variables and work, environmental and personal characteristics related to the pandemic. RESULTS: Prevalence rates of clinically significant depressive, anxious and post-traumatic symptoms were 57.6%, 63.5% and 54.8%, respectively. Female gender, worsening of relationship status and financial consequences due to the pandemic were the conditions most strongly associated with the presence of psychopathology. LIMITATION: The cross-sectional design of the study doesn't allow an evaluation over time of the sample. No assumption of causality can be made due to the lack of pre-pandemic assessments for the investigated variables. CONCLUSIONS: The impact of the pandemic involves depressive, anxious and post-traumatic dimensions. The investigated psychopathology correlates with several variables expressing the personal and environmental changes that occurred in the population due to the COVID-19 emergency. The study is multicentric and the recruitment of participants was held in a clinical setting, providing a realistic picture of the consequences of the pandemic in clinical practice within mental health services.

Social enterprises, vocational rehabilitation, supported employment: working on work in Italy.

Since Basaglia's pioneering work in the 1960s, programs geared to employment have been considered hallmarks of good practice in Italian community psychiatry. These programs mostly include "train and place" schemes: sheltered workshops, training placements and temporary grants with public/private employers, and social enterprises (cooperatives). Law 68/1982 on disability and work demanded a "quota of workplaces" to be reserved for citizens with disability by public and private employers, but application to the psychiatric field proved problematic. Despite large investments, outcomes in terms of competitive employment have decreased over the decades, and now, less than 10% of all attenders of these programs attain the open labor market. More recently, some "place and support" programs have been tried with promising results. Individual Placement and Support is practiced in one third of mental health centers in the Emilia-Romagna Region and in pilot programs in three more regions. It is difficult to forecast how the rapid changes brought by the current financial crisis will impact on Italy, but very likely, supported employment programs will find more space in Italian mental health services.