EAP in Italy Beginning to Overcome Challenges

By Maynard, John | The Journal of Employee Assistance, October 2017 | Go to article overview

EAP in Italy Beginning to Overcome Challenges


Maynard, John, The Journal of Employee Assistance


Italy boasts stunning mountains and alpine lakes, gorgeous coastlines, and world famous art, fashion, and cuisine. Along with its near neighbor, Greece, Italy is acknowledged as the birthplace of western culture.

What a treat, then, to learn that 2017's Employee Assistance European Forum (EAEF) conference would be held in Milan. Milan is Italy's second-largest city, and besides being renowned for fashion and design, it is Italy's main financial, industrial, and business center--a most appropriate place for a gathering of EA professionals from around Europe and the world.

The EAEF conference in June had a record 100 attendees from 25 countries and showcased the continued growth and maturation of EAP across Europe. I was fascinated to learn about the unique features of EAP in each country, and at the same time, the many interconnections among EA professionals throughout Europe, including Italy.

Economic Ups and Downs

Italy's diverse, but somewhat vulnerable, industrial economy has experienced significant volatility over the last 40 years. In general, the Italian economy enjoyed strong growth from the 1950s until the 1990s, and Italy became one of the original Euro zone countries. However, by the late 1990s, the economy began slowing, with economic growth lagging behind Europe's average in most years. By 2005, Italy had the worst economic statistics of all Euro zone countries. With its already shaky economy, Italy was particularly vulnerable and hard hit by the global recession in 2007-2008.

A number of structural features within the Italian economy helped create and perpetuate its economic struggles, and also contributed to a relatively slow start to the EA field. Geographically, Italy's industrial economy is clustered mainly in the north, while southern Italy is less economically developed and suffers higher unemployment. A large "underground" economy, estimated as high as 17% of Italy's GDP, means the government struggles to collect enough tax revenue to finance its needs. A history of government corruption and high government spending aggravates already difficult conditions. Recently, the migration crisis in the central Mediterranean region has added to economic stresses.

Health and Mental Health Care

Since 1978, health care in Italy has been delivered through a national health service funded by taxes and providing universal coverage to all citizens and residents. Routine waiting times are often up to several months in large public facilities and a few weeks in smaller private facilities, although more urgent cases can be seen more quickly. A "free market" option with much shorter wait times is available for patients who opt to pay completely out-of-pocket.

Mental health care in Italy was assigned in 1978 to regional public Mental Health Departments, which are charged with the management and planning of community-based medical and social activities related to prevention, treatment, and rehabilitation in their defined areas. Unfortunately, while the 1978 law that created the Mental Health Departments set out general principles and guidelines (such as using multi-disciplinary teams to provide effective continuity of care), it did not provide funding or specific standards for service provision and staffing. Only after a new national plan for mental health, which included funding and standards, was launched in 1994 did the comprehensive network of mental health services in each district really become effective (Piccinelli et al., 2002).

For the private sector, the difficult economy, along with the availability of comprehensive public mental health services, meant that Italian companies had very little interest in anything like EAPs. Some US-based multinational companies did expand their EAP services into their Italian locations but services, including client intakes, were still based outside the country. Not until the early 2000s did these multinationals begin to arrange for more local intake services. …

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