Disparities in mental health care provision to immigrants with severe mental illness in Italy.
OBJECTIVE
To determine whether disparities exist in mental health care provision to immigrants and Italian citizens with severe mental illness in Bologna, Italy.


METHODS
Records of prevalent cases on 31/12/2010 with severe mental illness and ≥1 contact with Community Mental Health Centers in 2011 were extracted from the mental health information system. Logistic and Poisson regressions were carried out to estimate the probability of receiving rehabilitation, residential or inpatient care, the intensity of outpatient treatments and the duration of hospitalisations and residential care for immigrant patients compared to Italians, adjusting for demographic and clinical covariates.


RESULTS
The study population included 8602 Italian and 388 immigrant patients. Immigrants were significantly younger, more likely to be married and living with people other than their original family and had a shorter duration of contact with mental health services. The percentages of patients receiving psychosocial rehabilitation, admitted to hospital wards or to residential facilities were similar between Italians and immigrants. The number of interventions was higher for Italians. Admissions to acute wards or residential facilities were significantly longer for Italians. Moreover, immigrants received significantly more group rehabilitation interventions, while more social support individual interventions were provided to Italians.


CONCLUSIONS
The probability of receiving any mental health intervention is similar between immigrants and Italians, but the number of interventions and the duration of admissions are lower for immigrants. Data from mental health information system should be integrated with qualitative data on unmet needs from the immigrants' perspective to inform mental health care programmes and policies.
Department of Biomedical and Neuromotor Sciences,Alma Mater Studiorum,University of Bologna,Bologna,Italy.
P
P
Rucci
Department of Mental Health and Pathological Addictions,Local Health Trust,Bologna,Italy.
A
A
Piazza
Department of Biomedical and Neuromotor Sciences,Alma Mater Studiorum,University of Bologna,Bologna,Italy.
E
E
Perrone
Department of Medical and Surgical Sciences,Alma Mater Studiorum,University of Bologna,Bologna,Italy.
I
I
Tarricone
Department of Mental Health and Pathological Addictions,Local Health Trust,Bologna,Italy.
R
R
Maisto
Department of Mental Health and Pathological Addictions,Local Health Trust,Bologna,Italy.
I
I
Donegani
Department of Mental Health and Pathological Addictions,Local Health Trust,Bologna,Italy.
V
V
Spigonardo
Department of Medical and Surgical Sciences,Alma Mater Studiorum,University of Bologna,Bologna,Italy.
D
D
Berardi
Department of Biomedical and Neuromotor Sciences,Alma Mater Studiorum,University of Bologna,Bologna,Italy.
M P
MP
Fantini
Department of Mental Health and Pathological Addictions,Local Health Trust,Bologna,Italy.
A
A
Fioritti
Equity; health services research; interventions; severe mental illness