Fulfilling the unmet need for psychosocial care among adolescents: UFDA 2022 pilot project in ULSS6

The novel coronavirus (COVID-19) crisis has highlighted the urgent need for a holistic approach to well-being, particularly for adolescents who faced unique challenges during the pandemic. The various disruptions caused by quarantine measures, changes in routines, and social isolation significantly impacted their mental health. A growing body of literature has reported the detrimental effects of the COVID-19 pandemic on adolescents' mental health, with increased rates of psychological distress and reduced life satisfaction worldwide. Italy, being severely affected during the pandemic, recognized the urgency to address the mental health gaps in young people. To address the urgent mental health needs of adolescents and their families, the legislative decree law n. 73 of 25 May 2021, converted and modified by law n. 106 of 23 July 2021, allocated 8 M EUR according to Article 33 of Law 106/21. These funds were intended to establish an innovative unit of Adolescent Neuropsychiatry, to be integrated into the Child and Adolescent Mental Health Services (CAMHS) in various regions and autonomous provinces of Italy. In response, the Veneto Region followed the guidelines outlined in the Resolution n. 1215/2021 of the regional council and allocated financial resources to establish an experimental pilot project known as the District Functional Unit for Adolescents (UFDA). The UFDA aims to comprehensively address the mental health needs of adolescents with a youth-centered approach. This study explores the data collected at the UFDA located in Padua's Local Health Unit (LHU; Azienda Unità Sanitaria Locale Socio Sanitaria (AULSS6)) and assesses the appropriateness and effectiveness of UFDA interventions against established standards of practice. The study had three main objectives: 1) Investigating the patient profile seeking help through UFDA by conducting a comprehensive needs analysis, 2) Evaluating whether UFDA has introduced improvements to the public mental health service for youth through individualized therapeutic projects and optimized intervention duration, and 3) Assessing the effectiveness of UFDA interventions in terms of psychological well-being improvements and their long-term sustainability using the Strengths and Difficulties Questionnaire (SDQ). Participants: A total of 255 adolescents participated in the study, representing approximately 71.43% of UFDA patients, and 170 parents or caregivers completed the informant version of the SDQ for adolescents. Results: The study revealed positive outcomes despite the limited number of psychotherapy sessions, with high self-referral rates and over 420 patients seeking support at UFDA during an 8-month period. The brief-focused therapy approach proved successful, with no therapeutic cycles exceeding 20 psychotherapy sessions. Most cases were successfully concluded, sent or suspended due to a temporary suspension of UFDA and are awaiting re-engagement, although some drop-outs were noted. The evaluation of UFDA interventions for psychological well-being revealed improvements in almost all SDQ scales following the intervention. The agreement between parents and adolescents on the SDQ reports showed a moderate to low association, with concordance observed only for a few subscales, consistent with existing literature. In conclusion, the UFDA pilot project demonstrates the potential for an age-sensitive service to address the mental health needs of adolescents, emphasizing the importance of collecting data for monitoring and evaluating such services. The study provides valuable insights for improving mental health care for young people in the post-COVID-19 era and potentially serves as a model for other regions or countries facing similar challenges.