New users of mental health services for adults in Tuscany (Italy). Characteristics of cases and pathways of care

: The aim of this cross-sectional study was to describe the characteristics and pathways of care for users ("first visits") of adult mental health services in Tuscany. A questionnaire was mailed to healthcare workers of mental health services in Tuscany. Overall 184 psychiatrists and psychologists replied (136 psychiatrists and 48 psychologists) Sixty three percent of new users of mental health services were female, 32.6% were aged 18 to 34 years (32.6%) and 4.4% were foreign-born. Waiting times were lower for seeing a psychiatrist with respect to a psychologist (9.0 days ± 8.5 versus 19.2 days ± 18.7; p < 0.001). Severity of disease was the main reason for accepting persons presenting to the mental health services as patients; this occurred in 87% of cases. Persons accepted as patients were younger (42.2 years ± 14.9 versus 51.0 years ± 20.9; p < 0.05) and had an earlier onset of symptoms with respect to those not accepted as patients (32.1 years ± 15.2 vs 39.7 years ± 19.7; p < 0.05). The average duration of the mental disorder at the time of contact with the mental health service was 10.1 years and only 1/3 contacted the health service within one year of onset of the mental disorder. In conclusion, the duration of the mental disorder of adult patients contacting mental health services is high. This highlights the need for the various community agencies (e.g social services, health agencies, etc.) to facilitate access to care for people with a mental disorder.