Italy's lockdown has taken heavy toll on mental health, say psychologists

Covid-19 has killed more than 32,000 people in Italy and wreaked havoc on the healthcare system and economy. But as the country creeps out of lockdown, the toll on mental health is beginning to become apparent.

In a recent survey by Italy’s order of psychologists (CNOP), eight in 10 Italians said they needed psychological support to overcome the pandemic, a much higher response compared with similar surveys done in the past.

Psychologists have also reported a rise in the number of people turning to them as they try to navigate the ongoing fear of the virus, the emotional impact of physical distancing and economic distress.

Sara Reginella, a psychologist in Ancona, in the Marche region, noted an increase in anxiety and depression at the beginning of the lockdown that was connected to the isolation of staying at home.

Even though some freedoms have been restored, she said many people have chosen to stay indoors as they feel safer there.

Now with Italy on the brink of a deep recession, psychologists warn of a cataclysm in mental health as people struggle with financial hardship.

“There are threats to people’s basic needs – they are losing their jobs and homes and worrying about providing for their children’s future,” Reginella said. “We’re not talking about self-fulfilment or spiritual needs but survival.”

Since the beginning of March, 37 people have killed themselves in Italy and 25 have attempted suicide, according to figures gathered by BRF Onlus, a mental health research foundation.

The National Federation of Nurse Guilds confirmed that four nurses on the frontline of the pandemic killed themselves, with the organisation attributing the cause to the overwhelming stress they endured. The suicides of two other people are known to have been triggered by the lockdown.

On 6 May, two days after Italy started to ease restrictions, the owner of a small business on the outskirts of Naples was found dead in his office. Another four small business owners attempted suicide during the first week of the month.

“From our research, suicides are only slightly higher than the average over two months,” said Armando Piccinni, the president of BRF Onlus. “We don’t know if these people were already depressed or receiving treatment. But what is alarming is that some of the cases were clearly related to the pandemic.”

The last time there was a marked increase in suicides in Italy, particularly among small business owners, was after the financial crisis of 2007. In the years before that, the suicide rate had been decreasing.

Maria Santa Lorenzini, a psychologist in Rome, has recently treated business owners who attempted suicide.

 “Enormous economic difficulties have been created,” she said. “Those who have a fixed income have coped better, but those whose income stopped when the lockdown started have not been helped sufficiently. Many have not yet received the financial assistance they were promised.”

Whether the pandemic and its economic ramifications trigger another rise in the number of suicides remains to be seen. However, Piccinni said suicides were the “tip of the iceberg” of the psychological impact. “For each suicide or suicide attempt, there are hundreds of people living in a state of terror or depression,” he added.

The pandemic and uncertainty have exacerbated anxiety and depression in those already suffering, while others are dealing with mental health issues for the first time.

Recognising this, the taskforce set up by the Italian government to navigate the country through the post-lockdown era includes the psychologist Elisabetta Camussi.

Camussi was unable to speak to the Guardian due to restrictions on interviews with the press, so it is unclear what the plan is to confront the challenges for mental health.

The World Health Organization warned last week that coronavirus “may never go away” and predicted a global mental health crisis caused by the pandemic was looming.

Italy’s psychologists have been playing their part in finding a solution, with thousands offering free consultations.

“We have done a lot voluntarily. This is OK but there is a limit,” said Reginella. “The government ought to pay us to continue offering services for free, as so many people don’t have the money for therapy. And unless a project of this kind is set up, people won’t get better.”

David Lazzari, the president of CNOP, said: “We need to intercept psychological discomfort and establish a system whereby people can easily access therapy. The government can certainly implement measures with the help of GPs, social associations and unions … we need a new infrastructure as we face problems that we didn’t have before.”