The service for Monitoring and Early Intervention against psychoLogical and mEntal suffering in young people (SMILE) at the University of L'Aquila: first year experience

Abstract

Aim: To establish a comprehensive early intervention service for young people with mental suffering in L'Aquila, Italy, and to evaluate its effectiveness in delivering user friendly integrated interventions. Methods: The S ervice for M onitoring and early I ntervention against psycho L ogical and m E ntal suffering in young people (SMILE) began operation in November 2005 under the auspices of the Department of Mental Health, University of L'Aquila, Italy. It is the mission of our service to reduce the burden of mental suffering in young people by means of an earlier recognition of signs and symptoms, systematic evaluation of psychological distress and promotion of attitudes that encourage young people to seek care. We also aim to reduce the delays that young people at incipient risk of severe psychiatric illness experience in accessing appropriate psychiatric care. Results: Between November 2005 and November 2006, 216 young people (127 women, 89 men; mean age 21.8 ± 5.7 years) were referred for assessment. Thirty‐five per cent of patients had a diagnosis of severe mental illness (schizophrenia, bipolar disorder, incipient risk of psychosis). In addition, 80.5% of patients were admitted to the service more than once, totalling 685 admissions. Treatment modalities comprised cognitive behavioural treatment (61.5%), integrated psychosocial treatment (25.5%) and psychopharmacotherapy (15.9%). Conclusions: The SMILE service provides most of the mental health service requirements for young people with various forms of psychological suffering in Italy. Moreover, it offers appropriate case management with an early multimodal approach.