Organization and functioning of the Italian Departments of Mental Health in the pandemic and post-pandemic period.

INTRODUCTION: The pandemic significantly affected mental health, leading to a reorganization of services. This study examines changes in Italy's Departments of Mental Health (DMHs), comparing surveys from 2021 (during COVID-19) and 2023 (post-pandemic). METHODS: The two surveys involved 19 Italian DMHs and covered variables related to mental health care (number of centres, available staff, services provided and intervention methods). RESULTS: Between 2021 and 2023, services show structural stability with a solid territorial network. Organizational changes point to greater flexibility and customization, with a stronger semi-residential hospital offer. Human resources give mixed signals: psychologists and health care social workers are increasing, while social workers and psychiatric rehabilitation technicians are decreasing. Clinically, hospitalizations in General Hospital Psychiatric Units (GHPUs), Emergency Department (ED) visits, and self-harm cases are rising, while psychiatric and psychological visits decline. Remote nursing and psychosocial interventions are increasing. The growth in first psychological consultations and users taken into care suggests a gradual return to in-person access and partial pre-pandemic normality. CONCLUSIONS: The data substantiate the need for continuous attention and adequate support to address post-pandemic mental distress, highlighting the importance of reorganizing services to effectively respond to the new needs of the population.