Mental health in ItalyItaly is the fourth most populous nation in Europe, with a population of 60.36 million people as of 2019. As it stands, Italy remains one of the most COVID-19 affected countries, and the resulting lockdown has had a noticeable impact on the mental health of the Italian population. However, there is more to the story of mental health in Italy than the effects of the pandemic.

Italy’s Past Relationship with Mental Health

Italy passed Law Number 180 in 1978. Law Number 180 blocked all new admissions to Italian mental hospitals. This subsequently led to all mental hospitals in Italy closing by the year 2000. This change came about so that mental patients would receive similar treatment to other patients with physical ailments. Psychiatric wards that still exist in the country are located inside general hospitals with roughly 10 available beds in these wards per 100,000 people, and only 46 beds per 100,000 people in community residential facilities. These numbers can also vary significantly between geographical areas.

The State of Mental Health in Italy

In the years leading up to the COVID-19 pandemic, Italy had been doing relatively well in terms of mental health. For example, in 2016, Italy had one of the lowest suicide rates among G7 countries, at 6.3 suicides per 100,000 people. This is less than half the rate of the United States in 2016, which was 13.3 suicides per 100,000 people. The World Health Organization (WHO) estimated that in 2017, 5.1% of the Italian population suffered from some form of depressive disorder and 5% of the population suffered from an anxiety disorder.

The Effects of COVID-19

The full effects of COVID-19 on mental health in Italy are unknown. However, psychological studies conducted while lockdown measures were in place provide some clarity on the subject. One online survey issued approximately four weeks into lockdown measures in Italy showed notably increased rates of post-traumatic stress syndrome, symptoms of depression, insomnia, symptoms of anxiety and perceived stress.

The Future of Mental Health in Italy

According to experts, there are going to be psychosocial and economic ramifications resulting from the COVID-19 pandemic. Additionally, due to the trauma associated with being a frontline worker, there is a projected decline in the mental health of frontline doctors and nurses. This decline will also affect members of the Italian population that have undergone any psychological distress because of the pandemic.

Steps have already been taken to help those suffering from COVID-19-related stress. In March 2020, the Italian government launched a national mental health service intended to combat the rise of mental distress in Italy. The program works with institutions and regional associations to provide free emergency help from psychoanalysts and psychologists. The new mental health service can also provide necessary mental resources to low-income families and individuals living independently as they are more at risk of developing mental health disorders.

Additionally, SOS Children’s Villages, an organization that has also taken action on the issue of mental health in Italy during COVID-19, has partnered with the International Federation of Red Cross and Red Crescent Societies, the City University of New York and the WHO to train individuals on how to provide low-intensity psychological interventions to individuals in need of psychological aid.

The “Living with the Times” toolkit made by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support also helps to provide adults with the tools necessary to support one’s mental health, as well as the welfare of those around them.

Italy has a unique relationship with mental health treatment, and COVID-19 presents an unusual challenge for the nation. Efforts by the institutions that have partnered with the Italian government, as well as local NGOs and nonprofits, aim to reduce the damage caused by COVID-19 by making mental health care widespread and accessible.

– Brendan Jacobs
Photo: Unsplash

The Healing Power of ArtWhile charities and humanitarian organizations ensure that children refugees receive food, blankets, shelter, vaccinations and malnutrition screenings, it is easy to overlook the other side of war and displacement – the psychological impact – and the healing power of art.

Refugees and Mental Illnesses

There are 25.9 million refugees around the world and over half of them are children under 18. Children refugees are more at risk of trauma and psychological disorders, such as post-traumatic stress disorder (PTSD), with rates ranging between 50 and 90 percent compared to 10 and 40 percent in adults. Even major depression rates are higher among children refugees than adults.

The distress caused by war is often chronic, with one study showing 45 percent of participants still suffering from depression and PTSD three years after the Bosnian war. Fourteen different studies also show a significantly higher trend of disturbance among displaced individuals living in refugee camps than nondisplaced individuals or those living temporarily with relatives, even when nondisplaced individuals experienced significant trauma.

According to UNICEF, 2.5 million Syrian children are living as refugees in Egypt, Iraq, Jordan, Lebanon and Turkey. In Jordan, nearly 100,000 out of the 1.4 million Syrian refugees reside in Za’atari, a refugee camp. Syrians refugees have no legal right to work in Jordan and tensions are mounting between the two populations. Humanitarian organizations are struggling to provide food, shelter and medical care, so people often overlook educational and creative activities for children.

Artolution and the Need for Art and Expression

According to Joel Bergner, co-founder of the public art organization, Artolution, “The kids, most of whom went to school in Syria, now roam the refugee camp with few rules or structured activities. They are very rough and frequently get into fights. Yet, at the same time, they are also really sweet and friendly.”

If the international community seeks to rebuild war-torn countries or reintegrate child refugees back into a functional society, then psychological treatment is just as necessary as the physical. The trauma of war will lose whole generations if people underestimate the healing power of art.

Bergner seeks to reverse the trend of trauma, aggression and marginalization by giving children something to do with their time and by recognizing the healing power of art. Advances in neuroimaging have shown that the Broca’s area of the brain, associated with speech and articulation, actually shuts down after an individual experience’s trauma. People call this change speechless terror, which makes expressing, and therefore, managing a trauma significantly harder. However, the sensory areas of the brain that process trauma also play a role in art-making. This allows creating art to become a voice for those unable to express their trauma and reconcile their emotions.

Art Therapy

The first use of the term “art therapy” was in 1942, following Adrian Hill’s service in World War I. Hill was a British soldier, author and an official war artist whose work highlighted the healing power of art-making. Since then, art therapy has taken on various forms beyond being a method for a therapist and patient to communicate. It can involve drawing, painting, dance, theatre and song.

According to the American Art Therapy Association, the art-making process helps foster self-awareness, manage behavior and develop social skills while reducing anxiety and increasing self-esteem. The most effective art therapy models, though, are those conducted in groups and that include a discussion. This helps prevent avoidance and emotional numbing often associated with PTSD.

The organization, Artolution, is a collaborative art-making project that connects children to positive role models and their peers, but it is not only that. In Za’atari camp, the Syrian artist, Jasmine Necklace, co-facilitated a community mural alongside Bergner as well as Syrian and Jordanian children. This practice allows for discussions among refugee youth so they can talk openly about their trauma.

Art therapist, Melissa S. Walker, says that she and her colleagues have seen the healing power of art therapy through its ability to overcome the speech-language barrier in veterans, allowing them to work through their traumatic experiences in a way that feels safe.

Art therapy programs such as these have found root across the world, as more organizations acknowledge the healing power of art. UNICEF helped develop a drama program in Slavonski Brod, a town in Eastern Croatia, to help children overcome the psychological effects of the Yugoslav Wars. A counseling project for Sudanese refugees utilized drawing, theatre, writing and storytelling to help children traumatized by civil war. The nonprofit organization, War Child, sponsors art-therapy projects in the Caucasus for children refugees and those damaged by war.

Just as any humanitarian organization seeks to improve the lives of children, art therapy projects help heal the psychological wounds of war. It gives refugees a channel to communicate and a chance to rebuild their communities.

– Emma Uk
Photo: Flickr


Does poverty lead to a negative state of mind, or does a negative state of mind lead to poverty? Are the two connected at all? What role does psychology play in understanding poverty?

The psychology of poverty is another facet of poverty’s debilitating toll on individuals. An article by the Association for Psychological Science states that people who deal with “stressors” like poverty and discrimination are more susceptible to physical and mental disorders.

Studies have demonstrated that children who grow up poor have lesser amounts of gray matter in their frontal and parietal lobes. Poverty also affects the size of their hippocampus and amygdala, parts of the brain responsible for memory, learning and processing social and emotional information. Furthermore, children from poor families have decreased access to cognitive stimuli. Cognitive stimuli include things such as books, computers and other learning resources. These effects impede a child’s learning ability.

Psychology Problems Linked to Poverty

Living in poverty, especially persistent poverty, increases an individual’s likelihood of suffering from anxiety, depression and attention problems. These are complex symptoms that provide more barriers to escaping poverty.

Martha J. Farah, a University of Pennsylvania professor, says that studies have shown that many people think that those who are poor are poor because they do not try hard enough. She says that neurons should not be blamed, though.

Commenting on Carson’s statement about poverty as a state of mind, Gary Evans, a professor at Cornell University, said that “he’s correct in identifying that there’s this link [between the state of mind and poverty], but I think he’s got the relationships backward.”

The American dream mentality that encourages individuals to pull themselves up by their bootstraps and march onward towards a better life has merit in its promotion of perseverance. Its harms, especially when intermingled with poverty, lie in its tendency to individualize progress. In other words, it may frown upon outside help. Furthermore, it may diminish the complexity of poverty’s hold on households.

The psychology of poverty further demonstrates its complexities. And complex problems rarely have simple solutions. Poverty is a beast that must be tamed collaboratively with individual insight, community collaboration, a national passion and global innovation.

Rebeca Ilisoi

Photo: Flickr

Psychological_Effects_of_Poverty
Bradley Ariza, a man living in the U.K. with his girlfriend and children, is stressed all the time. In addition to constant hunger and insecurity, he needs to carefully calculate every calorie he eats to make sure he has enough, and count every penny he spends to ensure that his finances remain in order. He feels the constant pressure to maintain certain living standards for his family. Poverty becomes a “physical and psychological condition,” not just an economic one.

Studying the psychological effects of poverty is not usually met with enthusiastic approval. In the past, such research was often tainted with racism. It was also accused of being a way of blaming the poor for their behavior. Sometimes it has been seen as unnecessary because of the belief that although the poor are more deprived, they are happier. However, scholarly and public opinions are becoming increasingly more open to studying the effects of poverty on psychology and behavior. It is slowly beginning to be seen as a way to tackle poverty.

Poverty creates a “mindset of scarcity,” as behavioral economists Sendhil Mullainathan and Eldar Shafir have termed it. People are more likely to focus on current, pressing issues rather than long-term ones, even if they might be as important to their well-being. For instance, Indian farmers might prioritize their coming harvest over vaccinating their children. Some researchers have even found that the IQ of Indian sugarcane farmers falls just before their harvest.

Studies have already shown that poorer people have elevated levels of stress, and it is also widely known that stress is linked to depression. Depression, which causes absenteeism and lower levels of productivity, costs the U.S. and U.K. up to one percent of their GDP each year. People who are suffering from extreme stress and depression are less likely to make long-term investments in their health and education. They are more inclined to seek short-term rewards rather than long-term ones because they find it harder to delay gratification. These psychological effects of living in poverty make it more difficult for people to climb out of it.

Researchers are now exploring whether lowering stress and depression can improve people’s mental states enough so that they make better financial decisions and are more motivated about their future. When they are offered more psychological-centered treatments, such as therapy or counseling, people might be more likely to build a path out of the poverty trap. Studying this connection could also help explain why aid sometimes does not seem to work as it should. Microloans, for instance, might be financially helpful, but the added stress to repay loans might make poorer people’s lives worse.

Direct aid, instead of microloans, might be more beneficial. Johannes Haushofer, founder of the Busara Center for Behavioral Economics, has started studying how stress affects one’s ability to make good financial decisions. He found that giving unconditional cash transfers to families lowered their levels of depression and stress. In turn, they were more likely to make long-term, thought-out financial decisions. The effects were especially prominent when the cash transfer was a big enough size and given to women.

Radhika Singh

Sources: Foreign Affairs, The Guardian, Harvard
Photo: The Prisma