With today’s article we want to once again deal with health services and the growing need for adequate responses in the field of mental health and psychological well-being .
To discuss the topic we will refer to a recent article Psychopandemic and risks of pharmacological abuse: what answers? by David Lazzari, President of the Council of the Order of Psychologists (CNOP) recently published on Huffpost, which in addition to highlighting the increase in psychological distress following the pandemic in all age groups, highlights how among the main forms of help adopted to intervene mainly involve the use of psychotropic drugs .
Let’s see what the effects of the pandemic are after a year?
The following data was reported in the article:
Compared to the data reported by the WHO before the pandemic according to which 17 million Italians were already suffering from psychological disorders (Kastel, 2019), today this discomfort has increased significantly in the form of anxious, depressive or mixed disorders .
The highest incidence is found in risk groups such as: veterans from intensive care affected by Covid-19, physically ill people who have not benefited from treatment due to fear of contagion or access limitations, people who have lost a relative, caregiver or relatives of people with illnesses or disabilities, people with greater or previous psychological fragility, healthcare workers.
Another worrying fact concerns young people, children and adolescents . In a survey by the CNOP Study Center (15.01.21) it emerged that 47% of parents with children between 3 and 14 years have emotional problems, in another survey carried out on children negative psychological states were highlighted in 62% of cases. Among adolescents, 6 out of 10 say they feel stressed and one in three would like psychological support (Unicef 20.11.20).
With respect to the increase in psychological distress, which treatments are most used?
According to some official data from the AIFA (Italian Medicines Agency) and the OECD (Organisation for Economic Cooperation and Development) show a significant
increase in the consumption of anxiolytics and antidepressants . According to President Lazzari of CNOP, this phenomenon is fueled by factors such as:
the reimbursement of drugs by the National Health System which for some categories are also free and generally more accessible than psychological treatments;
the lack of specialized figures such as psychotherapists in the public health system : in the NHS there is currently one psychotherapist available for every 12 thousand inhabitants and access to psychotherapies in the public sector is limited to a few, while in the private sector there are fewer and fewer who can afford a treatment (Lazzari, 2021).
What would be the preferable routes for people and services?
Lazzari highlights three aspects that highlight the advantages of psychotherapies with respect to people and with respect to saving public spending:
according to a series of research it has emerged that 7 out of 10 people would prefer psychological help to drugs (McHugh, 2013). Reviews of the scientific literature show a greater and more lasting effectiveness of psychotherapy for most of these situations (Huhn et al. 2014, Cuijpers et al . 2014, Lazzari, 2020);
Psychological interventions promote people’s resources and prevent any relapses especially in the medium and long term (Harryotaki et al. , 2014, Zhang et al ., 2018);
Finally, a data confirmed by economic cost-benefit analyzes say that 5 years after treatment, psychotherapy saves 1481 euros per person in the healthcare field and 2058 euros for society compared to drugs, proving to be more economically advantageous in 75% of cases (Rossi et al. 2019).
What advantages could be obtained with the introduction of Single Session Therapy in public services?
Given the situation identified, it is natural to imagine more accessible public services , especially with respect to psychotherapy . In this sense, Single Session Therapy would offer an increase in this response due to its characteristics, acting in preventive terms and saving the public response . Together with SST, the implementation of Walk-In/TSS services would also represent an enhancement of services in general terms and with low training costs.
The experience of Walk-In/SST services around the world demonstrates how through a brief training of psychologists, psychotherapists and other figures such as doctors and social
workers it would allow the creation of multidisciplinary teams capable of sharing an intervention method useful for responding to multiple needs , reducing waiting lists, reducing the use of self-care and the priority use of psychotropic drugs.
Conclusions
Providing more adequate mental health responses will be an important challenge for the future which will involve not only addressing this problem economically, but culturally. In this sense we borrow the words of Lazzari who claims that ” Continuing to think that every psychological problem is actually a brain problem is a cultural error that no serious science confirms. It is just an ideological prejudice that leaves millions of people to not listen, to misunderstanding, to the expropriation of fundamental dimensions of life. I believe it is time for serious reflection and mobilization on this issue. It is not a question of demonizing drugs but of overcoming them as the only or fundamental response offered to citizens .”
Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy
Bibliography
Cannistrà, F., & Piccirilli, F. (2018). Single Session Therapy: Principles and Practices . Giunti Editore.
Cuijpers, P., Sijbrandij, M., Koole, SL, M.S., Andersson, G., Beekman, A.T., Reynolds C.F. (2014). Adding Psychotherapy to Antidepressant Medication in Depression and Anxiety Disorders: a Meta-Analysis, The Journal of Lifelong Learning in Psychiatry .
“Future We Want”: the Manifesto of the very young for the post-COVID is born from https://www.unicef.it/media/future-we-want-manifesto-dei-giovanissimi-per-il-post-covid/
Hoyt, M. F., Bobele, M., Slive, A., Young, J., & Talmon, M. (Eds.). (2018). Single-session therapy by walk-in or appointment: Administrative, clinical, and supervisory aspects of one at a time services . New York, NY: Routledge.
Hoyt, M. F. & Talmon, M. (Eds.). (2014). Capturing the moment: Single-session therapy and
walk-in services . Bethel, CT: Crown House Publishing.
Huhn et al. 2014, Efficacy of Pharmacotherapy and Psychotherapy for Adult Psychiatric Disorders
A Systematic Overview of Meta-analyses
Maximilian Huhn, MD1; Magdolna Tardy, MSc1; Loukia Maria Spineli, MSc3; et al
Lazzari, D., Bottaccioli, A. M., Bottaccioli, F. (2020). Letter to the editor: Kim, S.-W., Su, K.-P. (2020) Using psychoneuroimmunity against COVID-19,, Brain, Behavior, and Immunity, 87: 170–171.
Lazzari, D., (2021), Psychopandemic and risks of pharmacological abuse: what answers?, Huffpost from www.huffingtonpost.it/entry/psicopandemia-e-rischi-di-aiuto-farmacologico-quali-rispetti_it_602cf3d2c5b6cc8bbf3823a2.
McHugh, R.K., Whitton,S.W., Peckham, A.D., Welge, A.J., Otto, M.W. (2013). Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders: A Meta-Analytic Review, The Journal of Clinical Psychiatry, 74(6):595-602.
Talmon, M. (1990). Single-session therapy: Maximizing the effect of the first (and often only) therapeutic encounter . San Francisco, CA: Jossey-Bass.