Failure to reduce benzodiazepine prescriptions through the implementation of a psychological intervention for insomnia in an Italian mental health service.

PURPOSE: Despite the evidence of higher effectiveness of psychological interventions for insomnia compared to pharmacological ones, drug prescriptions for insomnia remain frequent. This study has assessed patterns of prescriptions of BZDs for insomnia before and after the delivery of a training in psychological interventions to professionals working in the services of a Department of Mental Health in northern Italy. METHODS: The intervention consisted in two training sessions about psychological interventions for insomnia delivered to professionals of the participating services. The prevalence of users with a prescription of BZDs for insomnia in an index period after the delivery of the training was compared to the prevalence in an index period before the training. RESULTS: Among 727 people assessed for BZDs prescription at pre-intervention, 306 (42.1%, 95% CI 0.39-0.46) had a prescription, and 344 (49.2%, 95% CI 0.45-0.53) had a prescription among 699 people assessed at post-intervention, corresponding to a significant odds ratio of 1.33 to be prescribed with BZDs in the second index period compared to the first one. Psychological interventions were offered to a small group of patients. CONCLUSION: Prescribing attitudes of BZDs for insomnia were not modified after the training and delivery of a psychological intervention in a mental healthcare outpatient setting. Prescribing habits should be addressed more directly in training, and professionals should be more aware of risks of BZDs assumption. The failure in changing drug prescriptions in this study should prompt more real-world studies of the application of evidence-based strategies, particularly in outpatient mental health settings.

The Strategical Role of General Practitioner in the Prevention of Suicide: Preliminary Data From a Descriptive Study in the Province of Trento.

Suicide is a serious public health problem, as confirmed by the World Health Organization (WHO). It turns out to be, at least in part, preventable, but it is a complex problem, requiring complex solutions. Studies show us that about 44.5 percent of suicidal individuals would have expressed to someone, prior to the act, their intention to take their own life. Data in scientific literature specifically estimate that 44% of those who died by suicide had seen their general practitioner in the 30 days prior to the act. From this perspective, the general practitioner plays a potentially strategic role, as he or she can act as a "sentinel" in the early recognition of individuals in suicidal crisis and intervene directly, including by referring them to dedicated services. He can also disseminate correct information to the population and promote a culture of sensitivity and acceptance of vulnerabilities, facilitating the expression of possible distress and the potential request for help. In a community suicide prevention strategy, such as that of the Invitation to Life project, it was considered appropriate to investigate the knowledge and training needs of general practitioners in the Province of Trento in the present day, in order to specifically reorient training interventions to be developed in the future.

Suicidal Phenomenon in Pandemic Times. The Trentino's Reality.

Suicide is a major public health problem; according to the latest WHO data, it is among the top twenty causes of death in the world. After the sudden and unexpected spreading of a global pandemic in 2020, many mental health researchers have launched alarms about a possible suicide rates' rise, due to the inevitable consequences of the ongoing social and health emergency. However, recent articles in scientific literature have disconfirmed this thesis. Trentino also seems not to deviate from this dynamic: preliminary data, collected in an unconventional, and not yet official way, have been able to show that in 2020 the suicide rate remained stable. The finding that excludes up to date such a rise in rates does not unfortunately provide any guarantee that the situation will remain constant over time, and that there cannot be significant differences regarding gender, ethnicity, religious faith, sexual orientation or social class in determining a different impact of the current crisis on the suicidal phenomenon. Further studies and insights into the processing of the data in our possession are needed. Difficulties and uncertainties connected to the covid-19, with which it is now clear that the community will have to "learn to live together", could also in the medium and long term constitute a prolonged stress-generating element with a greater negative impact on the mental health of the population. It is essential, in light of the particular social and health situation we are experiencing, to carry out with even greater effectiveness, precision and continuity actions such as those promoted within the Invito alla Vita Project for the prevention of suicide, in order to guarantee the most effective prevention of this serious phenomenon. The psychological and social implications of the covid-19 pandemic will only be fully assessable in a few years, when the crisis will be effectively over. Only then we will be able to understand if the efforts put in place at a global level, and in particular in the province of Trento, have been effective in the managing of the suicidal phenomenon.

Can clinical use of Social Media improve quality of care in mental Health? A Health Technology Assessment approach in an Italian mental health service.

Clinical use of modern Information and Communication Technologies such as Social Media (SM) can easily reach and empower groups of population at risk or affected by chronic diseases, and promote improvement of quality of care. In the paper we present an assessment of SM (i.e. e-mails, websites, on line social networks, apps) in the management of mental disorders, carried out in the Mental Health Service of Trento (Italy) according to Health Technology Assessment criteria. A systematic review of literature was performed to evaluate technical features, safety and effectiveness of SM. To understand usage rate and attitude towards new social technologies of patients and professionals, we performed a context analysis by a survey conducted over a group of 88 psychiatric patients and a group of 35 professionals. At last, we made recommendations for decision makers in order to promote SM for the management of mental disorders in a context of prioritization of investments in health care.

Suicide and attempted suicide: epidemiological surveillance as a crucial means of a local suicide prevention project in Trento's Province.

The World Health Organization identifies suicide among the top 10 causes of death in many countries with an overall mortality rate of 16 per 100,000 inhabitants. Furthermore suicide attempts present a frequency 4-10 times greater than the suicidal events, representing also one of the main risk factors to lead to recurrent attempts of suicide. In 2008 the Autonomous Province of Trento launched a suicide prevention pogram called "Invitation to Life" which includes various interventions intended to counter the phenomenon of suicide in the region. Actually the epidemiological research upon the phenomenon of suicide in Trentino region is one of the main pillars of the project: it represents a fundamental requirement to identify risk and protective factors in the population in order to adopt more specific and effective preventive strategies. This article aims to present methods and instruments for epidemiological monitoring of suicide and attempted suicide which are applied in Trentino and to describe results after seven years from the beginning of the local prevention program "Invitation to life".