What do you have in mind?
Pican: We would need a task force, an operational team that can intervene quickly and effectively. There is not much time to waste. Mine is a message to the institutions. Here we are facing a real mass depression, caused by the virus and by the measures to contain it. I admit it: as a doctor of the hospital system, but also as a volunteer and as a freelancer, visiting patients in my office, I was unable to make people understand the great emergency that Italy is experiencing.
The figures for deaths from suicide have generally increased …
Picano: Impressive data that specialists know. I am thinking for example of the 10-20 age group. These young people risk paying a very high price in social and economic terms. Can we afford to burn a piece of the new generations? The ability to integrate is learned in this period of life, without stimuli we risk causing a wound that is difficult to treat. The lack of relationship determines the reduction of the person’s vitality and compromises his free choices, as Basaglia had well understood. Depression as a mental problem and as a disease has an impact on GDP which can be estimated at a 5 – 8% decrease.
The whole Italian health system is under discussion, such as investments and structure, but we hardly ever talk about widespread psychiatric suffering …
Picano: Public mental health services are sized to treat about 0.5 million people, one third of whom have depression. 10% of severe patients (the “psychotics”) tend to absorb 90% of the resources. There are no resources designed specifically for depression. It is estimated that psychiatry uses an average of 5% of health resources. There are many initiatives and resources in the public sphere for the treatment of depression, but the change of scenery is so drastic that one cannot think of using traditional methods to address the problem.
There is no more time …
Picano: When I say Task force I mean use of the digital system, resources dedicated to mass depression, integration and help to general practitioners, already subjected to enormous stress. The state must intervene, but volunteering also has the potential to organize and make itself known and there are many socio-cultural resources on which to graft rapid action. It is a question of putting these realities online and identifying a common goal. To make an authoritative name, Massimo di Giannantonio, of the Steering Committee of the Italian Society of Psychiatry, would be ready to move. And on the digital medicine front there is another great psychiatric expert, Professor Luca Pani, who is very sensitive on this issue.
But the CTS or the Higher Institute of Health, which are constantly following the pandemic?
Picano: The ISS published two documents between June and July 2020 on how to treat the single case of post-Covid depression. It is very well done, but here we need to face a mass phenomenon, a pandemic in the brains of nearly 20 million Italians. We must find a way to face this terrible “secondary wave”, with respect to the spread of Covid. We know the techniques for treating depression in detail, but applying them to such a large population is a whole new challenge. An independent treatment channel must be created for depressed patients, otherwise any strategic plan will fail. This involves a parallel organization to the current Mental Health Centers. I understand the political resistance, but the country must understand that we must allocate resources for depression
independent of those on general mental health. We need a transition to an advanced digital platform that manages resources and communication effectively, across the entire population. Only in this way do we have hope of recovering human energy for the Italy of the future.
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