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Front. Psychiatry | doi: 10.3389/fpsyt.2019.00844

Integrated programs for early recognition of severe mental disorders: recommendations from an Italian multicenter Project

Alberto Parabiaghi1,  Linda Confalonieri2*, Nadia Magnani3, Antonio Lora4, Emanuela Butteri5, Katia Prato6, Marco Vaggi7 and  Mauro E. Percudani2
  • 1Department of Neuroscience, Mario Negri Pharmacological Research Institute, Italy
  • 2Department of Mental Health and Addiction Services, Niguarda Ca 'Granda Hospital, Italy
  • 3Department of Mental Health, USL Tuscany Southeast, Italy
  • 4Department of Mental Health and Addiction, ASST Lecco, Italy
  • 5Department of Mental Health and Addiction Services, ASST Fatebenefratelli-Sacco, Milan, Italy
  • 6Department of Mental Health, ASST Rhodense, Italy
  • 7Department of Mental Health and Addiction Services, Local Health Unit 3 of Genoa, Italy

The onset of mental disorders often occurs in adolescence or young adulthood, but the process of early diagnosis and access to timely effective and appropriate services can still be a challenge. The goal of this paper is to describe a pilot implementation case of the Ultra-High Risk (UHR) paradigm in six Italian departments of mental health employing an integrated approach to address clinical practice and service organization for youth in a broader preventive perspective. This approach entailed the integration of the UHR paradigm with a service provision model which prioritize prevention and the promotion of local community coalitions to improve youth service accessibility. The multicenter Italian Project “Integrated programs for recognition and early treatment of severe mental disorders in youths” funded by the National Centre for Disease Prevention and Control (CCM 2013 Project) implemented in three Italian regions will be described. As a result of syner-gic actions targeting accessibility of young individuals to innovative youth mental health teams, a total of 376 subjects aged 15–24 years were recruited by integrated youth services within twelve months. Subjects have been screened by integrated multidisciplinary mental health youth teams employing standardized procedure and evidence-based clinical assessment instruments for at risk mental states in young subjects (e.g. Comprehensive Assessment At Risk Mental States). Consi-dering the three UHR categories included in CAARMS, the percentage of UHR subjects was 35% (n=127) of the sample. In conclusion, future strategies to improve the organization of youth mental health services from a wider preventive perspective will be proposed.

Keywords: At risk mental states, psychosis, Ultra-high risk (UHR), Early Intervention, Transition, Prevention strategies, Community coalitions

Received: 10 Jun 2019; Accepted: 24 Oct 2019.

Copyright: © 2019 Parabiaghi, Confalonieri, Magnani, Lora, Butteri, Prato, Vaggi and Percudani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: PhD. Linda Confalonieri, Department of Mental Health and Addiction Services, Niguarda Ca 'Granda Hospital, Milan, Lombardy, Italy, lindaconfalonieri@hotmail.com