Editorial – Mental health in Italy: 2025 recap and 2026 outlook

Abstract

2025 concludes with data we cannot ignore: 28% of the Italian population suffers from mental disorders, an increase of six percentage points compared to 2022 [1]. We face what Health Minister Orazio Schillaci has called a “true silent emergency” [2], a long wave triggered by the pandemic but rooted in deeper social transformations. Among young people the situation appears particularly critical: over 700,000 under-25s live with anxiety and depression problems [3], while the OECD 2025 report confirms that the prevalence of these disorders among under-20s grew by 20% between 2018 and 2022 [4]. Suicide represents the second leading cause of death among 15-29 year-olds in EU countries [5], data alone that should orient health policy priorities.

Against this backdrop, on December 3, 2025, the so-called Valditara Bill was approved with 151 votes in favor and 113 against [6]. The measure introduces the requirement for parental informed consent for student participation in sex and affective education courses in secondary schools, while prohibiting such activities in kindergartens and primary schools [7]. The debate surrounding the legislative process revealed deep fractures: on one side those claiming the educational primacy of the family enshrined in Article 30 of the Constitution [8], on the other those denouncing a “dramatic step backward” that risks excluding from training precisely those most vulnerable students [9]. Italy remains one of seven European countries without a mandatory sex education program in schools [10], despite international research documenting how structured programs contribute to preventing gender-based violence and sexually transmitted infections [11]. 2026 will see the measure’s passage through the Senate, with uncertain outcomes but significant implications for the psychological wellbeing of entire generations.

On the health policy front, the Ministry of Health has transmitted the new National Mental Health Action Plan 2025-2030 to the Unified Conference [12]. The document represents an attempt at systemic reorganization through a four-level care model with increasing intensity, with particular attention to service integration and the introduction of the “primary care psychologist” figure at national rather than regional level [13]. The six priority intervention areas include promotion and prevention with emotional literacy in schools, strengthening services for childhood and adolescence with dedicated transition teams, integration with the penal system, clinical risk management, socio-health integration through the Health Budget, and digital innovation [14]. The Plan dedicates particular attention to perinatal mental health, providing for early screening and mother-baby units for complex cases [15]. In Italy, suicide has been identified as one of the main causes of maternal death within the first year after birth, yet half of women known to be at high suicide risk postpartum had not been referred to mental health services [16]. The prevalence of perinatal depression stands at around 12.4% during pregnancy and 9.6% postpartum [17], making urgent the implementation of systematic screening protocols.

The Psychology Bonus, introduced in 2022 as a response to post-pandemic distress, tells a story of demand vastly exceeding supply: against over 360,000 applications in 2025, only about 7,000 beneficiaries were able to access the benefit [18]. The allocation of 9.5 million euros proved dramatically insufficient [19]. For 2026 funding may be reduced to 8.5 million [20], while from 2028 the measure will become structural with 8 million annually [21]. The gap between need and resources remains the unresolved issue that demands systemic rethinking of mental health services in the National Health Service.

Looking to 2026, several trends emerge poised to transform the psychotherapy landscape. Digital Therapeutics (DTx) represent one of the most promising innovations: software-based therapeutic interventions providing evidence-based treatments for specific disorders [22]. A 2025 Nature study demonstrated the effectiveness of gamified DTx interventions personalized through reinforcement learning algorithms in reducing depression and anxiety symptoms [23]. Germany is a pioneer in Europe with the DiGA system for digital therapy reimbursement [24], while Italy is still defining its regulatory pathways. DTx offer significant advantages in terms of accessibility, scalability, and personalization, but challenges remain regarding clinical validation and data privacy [25]. Experts predict 2026 will see acceleration in adopting AI-powered tools for practice management, treatment plan personalization, and between-session support [26].

However, integrating artificial intelligence in psychotherapeutic practice raises crucial ethical questions. A Brown University study presented in October 2025 identified 15 categories of ethical risk in LLM chatbots used for psychological support, highlighting systematic violations of American Psychological Association standards [27]. Issues include lack of contextual adaptation, inadequate therapeutic collaboration, inappropriate crisis management, and creation of false empathy [28]. The accountability question remains open: when a chatbot makes errors, who is responsible? [29] The future of psychotherapy will likely be hybrid, with clients wanting flexibility between in-person and online sessions [30], but the authentic therapeutic relationship remains irreplaceable.

Another trend destined to redefine the field is psychedelic-assisted psychotherapy. Research through 2025 shows promising results: 71% of PTSD patients treated with MDMA-assisted therapy report lasting relief at 12 months [31], while 58% of depression patients achieve remission with psilocybin [32]. The FDA has granted “breakthrough therapy” designation to psilocybin for treatment-resistant major depression and to MDMA for PTSD [33]. If Compass Pathways’ phase 3 trials succeed, FDA approval of psilocybin could come in 2026 [34]. The United States is conducting pioneering studies on veterans [35], while in Europe the regulatory framework remains fragmented. For Italy, where specific regulatory frameworks are still lacking, 2026 could represent the year of the first institutional debate on these innovative approaches. Significant in this regard is the launch, in January 2026, of the first Italian advanced training course in Psychedelic-Assisted Therapies, promoted by the Illuminismo Psichedelico Association [36]. The program, accredited for 50 ECM credits, is aimed at physicians, psychiatrists, psychologists and psychotherapists and provides 300 hours of training over 18 months, covering neurobiology and pharmacology of psychedelics, expanded states of consciousness, trauma and PTSD, legal and ethical aspects, and phenomenology of the psychedelic experience. The American Psychological Association has included psychedelic-assisted therapies among the 10 most significant trends for the future of psychology, emphasizing the need to train competent professionals in this emerging field [37].

On the adolescent front, WHO Europe data show that problematic social media use increased from 7% in 2018 to 11% in 2022, with higher percentages among girls [38]. The German National Academy of Sciences Leopoldina has described the situation as part of a “global youth mental health crisis” [39]. In conclusion, prevention and early identification are becoming strategic priorities: through analytics, routine screening, and predictive models, organizations are building systems capable of identifying warning signs before patients reach the emergency department [40].

Conflict of Interest

The author declares no conflict of interest.