Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Jan 25, 2022; 11(1): 73-81
Published online Jan 25, 2022. doi: 10.5501/wjv.v11.i1.73
Rethinking hospital psychiatry in Italy in light of COVID-19 experience
Marco P Piccinelli, Paola Bortolaso, Greg D Wilkinson
Marco P Piccinelli, Paola Bortolaso, Psychiatric Unit Verbano, Department of Mental Health and Substance Abuse, Cittiglio 21033, Varese, Italy
Greg D Wilkinson, Liverpool University Hospitals NHS Trust, Liverpool University, Liverpool 2170, United Kingdom
Author contributions: Marco P Piccinelli and Paola Bortolaso designed the study, performed acquisition, analysis and interpretation of the data, and drafted the initial manuscript; Greg Wilkinson revised the article critically for important intellectual content and edited the manuscript.
Institutional review board statement: The paper did not require Institutional Review Board Approval.
Institutional animal care and use committee statement: Not applicable.
Clinical trial registration statement: Not applicable.
Informed consent statement: Data included in the paper were collected as part of routine clinical practice not requiring ethical approval, with patients giving their written informed consent at data collection at the time of hospital admission.
Conflict-of-interest statement: All authors confirm that there are no financial or personal relationships with any people or organizations that could inappropriately influence the actions of any author of this manuscript.
Data sharing statement: No additional data are available.
STROBE statement: All authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco P Piccinelli, MD, MPhil, PhD, Psychiatric Unit Verbano, Department of Mental Health and Substance Abuse, Via Marconi 40, Cittiglio 21033, Varese, Italy. marcopiero.piccinelli@asst-settelaghi.it
Received: March 11, 2021
Peer-review started: March 11, 2021
First decision: July 15, 2021
Revised: August 13, 2021
Accepted: January 3, 2022
Article in press: January 6, 2022
Published online: January 25, 2022
Research background

The coronavirus disease 2019 (COVID-19) pandemic forced a re-organization of mental health services at all levels of care. However, most accounts of changes occurring in Italy during the pandemic have been mainly narrative with little reliance on data.

Research motivation

The present study was based on a quantitative data-driven approach to the effects of COVID-19 pandemic on admissions to an inpatient psychiatric unit in Italy.

Research objectives

To explore changes in number of psychiatric admissions to an inpatient psychiatric unit during the COVID-19 pandemic in 2020 and to identify relevant factors associated with the detected changes in comparison with the same time period of 2019.

Research methods

All admissions were recorded to an inpatient psychiatric unit between February 24 and May 24, 2020 and compared with those occurring over the same time period in 2019. A 20-item checklist was completed to identify relevant factors leading to hospital admission.

Research results

During the COVID-19 pandemic hospital admissions dropped significantly compared to 2019 and were more likely to be related to difficulties in organizing care outside the hospital and in patients' family context. On the other hand, admissions related to logistic and communication difficulties pertaining to residential facilities were more common in 2019, due to the re-organization of these facilities as close communities looking after their own patients during the pandemic.

Research conclusions

Mental health services in general, and hospital psychiatry in particular, were forced to face new and different challenges during the COVID-19 pandemic. The Italian community-based model of care with a multidisciplinary team serving a well-defined catchment area had the potential to ensure a proper and rapid re-organization of mental health service activities.

Research perspectives

Since the COVID-19 pandemic is slowly decreasing and the associated limitations persist, the detected changes are expected to last and turn into the usual way of working. Therefore, an ongoing evaluation of mental health service organization, activities and requirements is mandatory to sustain and improve actual efforts.