1,721,008 research outputs found
Il costo della crisi in termini di salute mentale: il caso di Modena
No full textLa grande recessione ha causato costi tangibili in termini di tagli nell’occupazione e nella riduzione del reddito nei Paesi Europei. L’incertezza derivante dalla perdita del lavoro e l’espandersi di condizioni lavorative precarie sono state individuate in letteratura come possibili determinanti di una precaria salute mentale. La letteratura esistente sulla disoccupazione e la salute mentale mostra chiaramente una riduzione del benessere individuale durante il periodo di disoccupazione e un miglioramento dello stesso una volta ritrovato il lavoro. Questo studio mira ad identificare la relazione esistente tra lo stato di occupato e la salute mentale nella provincia di Modena che è stata colpita, oltre che dalla crisi economica, anche dal terremoto nell’anno 2012. I risultati, basati sull’analisi di due indagini sulle condizioni socio-economiche delle famiglie di Modena (ICESmo2 riferita all’anno 2006 e ICESmo3 riferita all’anno 2012), indicano un effetto negativo sulla salute mentale provocato dalla crisi, con una dimensione più grande di quella osservata nella media italiana. Inoltre, si osserva una riduzione dell’indice di salute mentale più accentuata per le donne e si registra un effetto negativo della disoccupazione sulla salute mentale e la residenza in un’area colpita dal terremoto
The adverse impact of joblessness on mental health.The case of Modena district in Italy
No full textThe Great Recession has caused tangible costs in terms of cuts in employment and income in European countries. The uncertainties connected to the increased joblessness and spread of precarious employment have been found in the literature as possible determinants of bad mental health. This paper addresses the topic by using local microdata to measure the impact of the crisis on mental health in a specific context. Multivariate analyses based on the 2006 and 2012 Surveys on Income and Living Conditions of Households (ICESmo) living in Modena district in the North Italy (that allows comparison with pre-crisis microdata) and administrative source of data highlight a decrease in mental health more accentuated for women. Empirical findings also suggest a positive impact of active labour market policies in addressing the lack of employment with special reference to mental disabilities
Health Outcomes and Patient Empowerment: The Case of Health Budgets in Italy
No full textScholars claim that the outcomes of health interventions are the products of three factors: the size, the penetration and the sustainability of their effects. Nonetheless, the prevailing biomedical ethic of care engenders a mere ‘fix-it’ approach, which focuses on the clinical treatment of the disease and neglects the role of patients in the process of care. This approach undermines both the size and the penetration of health interventions. From this standpoint, the authors examine different health interventions aimed at improving the size and the penetration of their effects through the empowerment of the patients and their involvement in the provision of care. They are confronted in terms of two different criteria: the ‘intensity’ of the health care co-production and the ‘breadth’ of the health-related needs contemplated. Besides, their outcomes—in terms of health status improvement, patients’ satisfaction and cost savings—have been contrasted. A detailed case study dealing with a pilot project launched in Italy, which involved full-fledged empowerment of the patient, is presented. It is compared with similar initiatives carried out in other European and non-European countries, with the purpose of stressing the peculiarities of the former and explaining the reasons for its success. The findings of this study support the exploratory hypothesis that the higher the intensity of co-production and the wider the breadth of health-related needs considered, the better the outcomes of health interventions
L'impatto di politiche attive di salute mentale in tempi di crisi economica: il caso di Modena
No full textScopo
La crisi economica e la successiva recessione hanno causato tagli all’occupazione su
scala mondiale. L’incertezza per la perdita del lavoro e le condizioni lavorative
precarie sono stati individuati come determinanti negativi per la salute mentale. Il
nostro obiettivo è stato quello analizzare l’impatto della disoccupazione sulla
salute mentale nella provincia di Modena (colpita oltre che dalla crisi economica
anche dal terremoto del 2012), e se questo si sia stato più importante nelle zone
interessate dal sisma.
Metodi
Sono stati utilizzati i dati di due indagini sulle condizioni socio-economiche delle
famiglie residenti: ICESmo2 (2006) e ICESmo3 (2012) confrontati con osservazioni su
base nazionale (ISTAT 2014). Per la valutazione degli effetti della crisi economica
sulla salute mentale locale sono stati utilizzati microdati ricavati dal Sistema
Informativo del Dipartimento di Salute Mentale e Dipendenze Patologiche dell’AUSL di
Modena.
Risultati
Nel 2012 la provincia ha mostrato di risentire molto della crisi con effetti
significativi in termini di tassi di disoccupazione e riduzione del reddito. Sebbene
l’indice di salute fisica nella provincia di Modena sia rimasto stabile, l’indice di
salute mentale è diminuito più della media nazionale. Gli effetti della crisi
economica sulla salute mentale in termini di utilizzo dei Servizi Sanitari hanno
mostrato una maggior frequenza di sintomatologia depressiva e dell’utilizzo di
psicofarmaci; in particolare una situazione di “non lavoro” è stata associata a
sintomi depressivi più evidenti. Inoltre, l’effetto del terremoto sembra aver
ulteriormente indebolito gli indici di salute mentale come variabile addizionale e
indipendente.
Conclusioni
Entrambe le analisi hanno confermato l’impatto negativo della crisi sulla condizione
di benessere psicologico. I dati locali hanno evidenziato come tale effetto sia
stato più accentuato nella provincia di Modena rispetto alla media nazionale con un
conseguente aumento della domanda di Servizi di Salute Mentale. Segnaliamo dunque
l’importanza di politiche di sostegno per la salute mentale soprattutto in tempi di
crisi e l’utilità di progetti di inserimento lavorativo per soggetti con disagio
psichico
Crisi economica e salute mentale: analisi multi-livello nella provincia di Modena
No full textLa grande recessione ha causato costi tangibili in termini di tagli nell’occupazione e nella riduzione del reddito nei Paesi Europei. L’incertezza derivante dalla perdita del lavoro e l’espandersi di condizioni lavorative precarie sono state già da tempo individuate come determinanti di una precaria salute mentale. Questo studio utilizza dati sanitari per evidenziare come con la crisi economica si sia osservato un peggioramento significativo del benessere psicologico e un aumento del ricorso agli antidepressivi nella Provincia di Modena, con effetti più accentuati nelle zone interessate dal terremoto. La ricerca effettuata conferma un effetto negativo sulla salute mentale: le difficoltà finanziarie, la disoccupazione e l’indebitamento sono associate ad ansia e depressione e, più specificatamente, a “depressione motivata”. Nella Provincia di Modena, caratterizzata generalmente da elevati standard sociali ed economici, la prolungata crisi economica ha avuto un impatto maggiore, ampliato ulteriormente nelle zone che hanno anche dovuto affrontare l’evento traumatico del terremoto del 2012. Dalla ricerca però non emergono solo dati negativi. Lo studio evidenzia infatti in modo altrettanto chiaro l’efficacia (valutata in termini di riduzione del numero e della durata dei ricoveri) dei programmi di inclusione e coinvolgimento in politiche attive del lavoro anche in chi soffre di disturbi psichiatrici gravi
Being hit twice: The psychological consequences of the economic crisis and an earthquake
No full textBACKGROUND:
The Great Recession has caused worldwide tangible costs in terms of cuts in employment and income, which have been widely recognised also as major social determinants of mental health. Italy has not been spared from the financial crisis with severe societal and mental health consequences. In addition, a strong earthquake hit the province of Modena, Italy, in 2012, that is, amid the crisis.
AIMS:
In this study, we explored and investigated the possible additional impact of concurrent events such as economic crisis and a natural disaster.
METHODS:
Our analysis elaborated data from two local surveys, ICESmo2 (2006) and ICESmo3 (2012), and a national survey carried out in 2013 by the Italian National Institute of Statistics (Istituto Nazionale di Statistica (ISTAT)). A regression model was adopted to distinguish the effect of the crisis and the earthquake.
RESULTS:
Our analysis confirmed the negative effect of the economic crisis on psychological wellbeing, but within the province of Modena such an effect resulted as even stronger compared with the rest of Italy, particularly within those areas struck by the earthquake.
CONCLUSION:
Being hit by a combination of two major negative events might have a significantly increased negative effect on psychological health. The higher repercussion observed is not only attributable to the occurrence of a natural disaster but can be reasonably related to the additional effect of unemployment on psychological dimensions
Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.
Full text linkIntroductionIn mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare.MethodsA cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses.ResultsIn Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs.DiscussionThe evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system
Self-reported unemployment status and recession: An analysis on the Italian population with and without mental health problems
No full textDuring economic recession people with mental health problems have higher risk of losing
their job. This paper analyses the issue by considering the Italian rates of unemployment
amongst individuals with and without mental health problems in 2005 and 2013, that is prior
and during the economic crisis.
We used data from the National surveys on Health conditions and use of health services
carried out by the Italian National Institute of Statistics (ISTAT) for the years 2005 and 2013.
The surveys collected information on the health status and socioeconomic conditions of the
Italian population. Self-reported unemployment status was analysed amongst individuals
with and without reported mental health problems. In addition, descriptive statistics were
performed in order to detect possible differences in the risk of unemployment within different
regional contexts characterised by different socio-economic conditions.
The recession determined increased disparities in unemployment rates between people
with and without mental health problems.
The analyses confirm that in periods of economic crisis people with mental health problems
are at risk of experiencing exclusion from labour market. In addition, the impact is even
worse within the group with low education and younger age.
These findings emphasise the importance of specific interventions aimed at promoting
labour market participation and reintegration for people with mental health problems
Feasibility and effectiveness of a combined individual and psychoeducational group intervention in psychiatric residential facilities: A controlled, non-randomized study
No full textThis controlled, non-randomized study explored the feasibility of introducing a Combined Individual and Group Intervention (CIGI) for users with mental disorders in residential facilities, and tested whether users who received the CIGI had better functioning than users who received the Treatment-As-Usual (TAU), at two-year follow up. In the CIGI, a structured cognitivebehavioral approach called VADO (in English, Skills Assessment and Definition of Goals) was used to set specific goals with each user, while Falloon's psychoeducational treatment was applied with the users as a group. Thirty-one professionals attended a training course in CIGI, open to users' voluntary participation, and applied it for two years with all users living in 8 residential facilities of the Mental Health Department of Modena, Italy. In the same department, 5 other residential facilities providing TAU were used as controls. ANOVA for repeated measures showed a significant interaction effect between users' functioning at baseline and follow up assessments, and the intervention. In particular, change in global functioning was higher in the 55 CIGI users than in the 44 TAU users. These results suggest that CIGI can be successfully introduced in residential facilities and may be useful to improve functioning in users with severe mental disorders
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