Context
Mental health is one of the main challenges for healthcare systems worldwide. In 2021, in Europe and Italy, about one in six people suffer from mental disorders, which affect not only individual health but also the socio-economic fabric. In particular, anxiety and depression are among the most common disorders in Italy. These conditions have a strong impact on the working-age population (20–64 years) and result in a number of years lived with disability almost 10 times as high as those caused by cancer. There is also great concern due to the increase of mental health problems since COVID-19 and the increase in incidence of psychological problems in the adolescent and young female population (Ministry of Health, 2024).
A further concern is the probable underdiagnosis of mental disorders in many Italian regions, as shown by marked differences in treated prevalence, which vary significantly from area to area. This disparity suggests uneven healthcare services and diagnostic capacity across the country.
The economic burden of mental health conditions is also substantial. They account for 3.3% of Italy’s GDP, with over EUR 20 billion in losses tied to reduced productivity and labour market participation (Ambrosetti, 2025).
Despite this, mental health received only 3.3% of total healthcare expenditure in 2022 – well below the European average of 5% (Ambrosetti, 2025).
The framework for mental health care in Italy still largely rests on the Basaglia reform (Law 180 of 1978), which marked a paradigm shift by closing psychiatric hospitals and promoting a community-based care model. In the following years, targeted initiatives defined by national health planning were implemented – such as the Objective Project for Mental Health Protection (1998–2000), the development of Community Mental Health Centers, and dedicated programs for early intervention in youth – and certain services were incorporated into the Essential Levels of Assistance.
However, significant regional disparities persist, along with a notable shortage of resources, staff and monitoring tools.
Main measures
The new National Mental Health Plan 2025–2030, approved by the State-Regions Conference in July 2025, is set within this context with the aim of strengthening and innovating Italy’s mental health care system. The plan promotes an integrated, multi-layered approach focused on prevention, inclusion and timely interventions.
The document is based on three key pillars:
- It adopts a bio-psycho-social model that goes beyond the traditional clinical approach by considering social, environmental and relational factors influencing mental health.
- It embraces the One Health/One Mental Health concept, aligned with WHO and European Commission guidelines, recognizing the interconnection between physical, psychological, environmental and social health.
- It places the individual at the centre, viewing them not just as a patient but as an active participant in their care, supported by families, caregivers and professionals in a collaborative and participatory manner.
The plan is structured around six key strategic areas:
- Promotion, prevention and care
- Childhood and adolescence
- Justice and security measures
- Risk management and safety
- Social and healthcare integration
- Training and research
It also introduces a four-level care model designed to provide progressive and flexible access to services. A major innovation is the introduction of the primary care psychologist within community centres, who will offer free, non-medicalized support for mild to moderate mental health issues, helping with guidance and easing the burden on specialized services. Special attention is given to severe and complex mental disorders through the introduction of a “case manager” responsible for personalizing and coordinating the therapeutic pathway, ensuring continuous support especially for marginalized individuals or those involved in the justice system.
Finally, the plan acknowledges the importance of digital technologies, such as tele-visits and teleconsultations, which are already well-established in other countries, promoting their use as a complement to traditional services. In this context, the potential of artificial intelligence to innovate medicine and mental health care is also highlighted.
The 2025–2030 National Plan lays the foundation for structural and cultural change, but a collective effort is needed to turn intentions into reality: adequate resources, trained personnel and continuous attention to local needs will be crucial to restoring dignity and rights to people living with mental distress.