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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2012; 12: 7.
Published online Jan 30, 2012. doi:  10.1186/1471-244X-12-7
PMCID: PMC3310734
The characteristics and activities of child and adolescent mental health services in Italy: a regional survey
Laura Pedrini,1 Giovanni Colasurdo,2 Stefano Costa,3 Michela Fabiani,4 Linda Ferraresi,5 Emilio Franzoni,6 Francesca Masina,7 Renato Moschen,8 Vittoria Neviani,9 Stefano Palazzi,10 Roberto Parisi,11 Antonia Parmeggiani,12 Antonio Preti,13 Cosimo Ricciutello,14 Marco BL Rocchi,15 Davide Sisti,15 Antonio Squarcia,16 Stefano Trebbi,17 Donatella Turchetti,18 Paola Visconti,19 Andrea Tullini,20 and Giovanni de Girolamocorresponding author1, the PREMIA Group
1IRCCS Centro San Giovanni di Dio-Fatebenefratelli, Brescia-Italy
2AUSL di Forlì, UONPIA, Forlimpopoli-Italy
3UOS Psichiatria e Psicoterapia età evolutiva, Ospedale Maggiore, Bologna-Italy
4AUSL di Reggio Emilia, UONPIA, Reggio Emilia-Italy
5AUSL di Modena, UONPIA, Sassuolo (MO)-Italy
6A.O. Universitaria Orsola-Malpighi, Bologna-Italy
7AUSl di Cesena, UONPIA, Cesena-Italy
8U.O. NPI Ospedaliera-Psicopatologia dell'Adolescenza e U.O. NPI Ospedaliera-Neurologia RIMINI-Italy
9Il Nespolo, Ospedale Privato Villa Igea, Modena-Italy
10AUSl di Ferrara, UONPIA, Ferrara-Italy
11AUSL di Piacenza, UONPIA, Piacenza-Italy
12IRCCS Institute of Neurological Sciences and Department of Neurological Sciences, University of Bologna
13Department of Psychology, University of Cagliari-Italy
14AUSL of Imola, UONPIA, Imola (BO)-Italy
15Institute of Biomathematics, University of Urbino-Italy
16AUSL di Parma, UONPIA, Parma-Italy
17AUSL di Bologna, UONPIA, Monzuno (BO)-Italy
18AUSL di Ravenna, UONPIA, Ravenna-Italy
19AUSL di Bologna, Ospedale Maggiore, Bologna-Italy
20AUSL di Rimini, UONPIA, Rimini-Italy
corresponding authorCorresponding author.
Laura Pedrini: lpedrini/at/fatebenefratelli.it; Giovanni Colasurdo: g.colasurdo/at/ausl.fo.it; Stefano Costa: stefano.costa/at/ausl.bologna.it; Michela Fabiani: fabianim/at/ausl.re.it; Linda Ferraresi: l.ferraresi/at/ausl.mo.it; Emilio Franzoni: emilio.franzoni/at/unibo.it; Francesca Masina: francesca.masina/at/gmail.com; Renato Moschen: Renato.Moschen/at/auslrn.net; Vittoria Neviani: v.neviani/at/villaigea.it; Stefano Palazzi: s.palazzi/at/ausl.fe.it; Roberto Parisi: r.parisi/at/ausl.pc.it; Antonia Parmeggiani: antonia.parmeggiani/at/unibo.it; Antonio Preti: apreti/at/tin.it; Cosimo Ricciutello: c.ricciutello/at/ausl.imola.bo.it; Marco BL Rocchi: marco.rocchi/at/uniurb.it; Davide Sisti: davide.sisti/at/uniurb.it; Antonio Squarcia: asquarcia/at/ausl.pr.it; Stefano Trebbi: stefano.trebbi/at/ausl.bologna.it ; Donatella Turchetti: d.turchetti/at/ausl.ra.it; Paola Visconti: paola.visconti/at/ausl.bo.it; Andrea Tullini: Andrea.Tullini/at/auslrn.net; Giovanni de Girolamo: gdegirolamo/at/fatebenefratelli.it
Received July 22, 2011; Accepted January 30, 2012.
Abstract
Background
To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence.
The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years.
Methods
Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail.
Results
Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years.
Conclusion
The percentage of young people in contact with CAMHS for mental disorders is in line with those observed in previous epidemiological studies. The overall number of child psychiatrists per 100,000 inhabitants is one of the highest in Europe and it is comparable with the most well equipped areas in the US. This comparison should be interpreted with caution, however, because in Italy, child psychiatrists also treat neurological disorders. Critical areas requiring improvement are: the uneven utilisation of standardised assessment procedures and the limited availability of dedicated emergency services during non-office hours (e.g., nights and holidays).
Keywords: Child and Adolescent Mental Health Services (CAMHS), Process of care, Adolescence, Child Psychiatry
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