Warning signs

The pediatric neuropsychiatric doctors of the Piedmont, Valle d'Aosta and Liguria regions have recently written an open letter addressed to the main health authorities of the same three regions (as well as to those at national level and to the various press bodies), to seek to bring to everyone's attention the serious emergency situation they are facing in this difficult period marked by the pandemic. The text of the letter aims to be "a multi-voiced appeal aimed at sharing awareness of what is happening to minors in care, their already fragile families and operators, in terms of suffering and damage (loss of health) over time".

In particular, they report an increase in alarm in younger children with regard to problems relating to sleep, nutrition, somatization, the disappearance of socializing educational opportunities, but above all doctors report a "marked mental suffering witnessed by the exponential growth access to the emergency room, requests for hospitalization and urgent visits for pre-adolescent and adolescent children… ». "We are witnessing a sharp increase in internalizing pathologies (anxiety, depression, phobias, social withdrawal), disruptive disorders and destructive pathologies in all its forms (severe eating disorders, self-harm) and suicidality, expressed and implemented in infants more and more precocious than in the past ». Is all this due only to the pandemic? No, this is a situation that was already in place before the outbreak of the infection, but which has been and still is certainly and seriously strengthened by the global crisis linked to the pandemic. The analysis is clear: "The Services of NPI (Child NeuroPsychiatry) have unfortunately had to witness in recent years an unstoppable and worrying increase in psychiatric disorders in childhood and adolescence, probably to be related to historical changes in society, such as the disintegration of family and social ties, the fall of the ethics of limits and the collapse of the educational system.

The current pandemic emergency and the consequent social trauma add to the already existing serious crisis and therefore oblige us to highlight the need for a new work model ». Recall that on January 30, 2020, the WHO declared that the Covid-19 epidemic is a public health emergency of international interest. The virus has already had a direct negative impact on the mental health of millions of people and is thought to pose a threat to mental health worldwide. What to do?

The letter first and foremost strongly denounces to the institutions the current lack of adequate basic resources, which includes:
Serious shortage in the number of beds dedicated to patients related to NPI care.
Numeric shortage at the level of staff, in particular NPI doctors.
Numeric shortage in the NPI and DH (day hospital) departments of other professional figures (psychologists, educators, social workers).
Shortage or absence of psychiatric rehabilitation educators / therapists.
Inadequate number of postgraduates in Postgraduate Schools.
Insufficient staff training in the NPI and Pediatric Departments.
Insufficient and uneven adequacy of the structures in the various territories.

Then new proposals are presented, both with regard to prevention (primary, secondary and tertiary) and with regard to the care of young patients, in order to "find together new paths to follow in a constructive and constructive perspective".
A decisive appeal, which "draws attention to emerging critical issues with the aim of identifying possible solutions and responding more appropriately and effectively to an unprecedented historical phase that will inevitably leave its mark on our society and on generations to come" . Let's think about it.

Gabriella del Pero
NP May 2021