La funzione di contenimento delle comunità terapeutiche durante la pandemia Covid-19
The response of therapeutic communities (TCs) to the pandemic emergency has not yet been studied in depth, despite the fact that the Istituto Superiore di Sanità (Higher Institute of Health) has stressed the close relationship between the pandemic and substance and behavioural addictions: while on the one hand, the Covid-19 context has aggravated problems of mental distress and led to an increase in the consumption of alcohol, psychotropic drugs and other substances, on the other hand, drug-addicted individuals and/or those with a psychiatric diagnosis, given their greater socio-sanitary vulnerability, run a greater risk of becoming infected and developing severe complications.
The C-O-V-I-D experimental research measured the effectiveness of the measures taken by the TCs to combat infection and assessed the coping skills of guests and operators through the administration of paper and online questionnaires and interviews. The study, conducted between November 2020 and January 2021, involved 134 guests and 97 operators from 12 therapeutic communities belonging to the Italian Federation of Therapeutic Communities specialised in the treatment of patients with dual diagnosis.
The measures for the prevention of Sars-CoV-2 infections adopted by the TCs were evaluated as effective by all the operators interviewed. This perception was reflected in the low number of positive cases in the TCs. However, physical distancing, the use of personal protective equipment and preventive and restrictive quarantines partially compromised the provision of care services. The majority of patients expressed nonetheless satisfaction with the support they received from caregivers and felt that they maintained a stable level of well-being. Caregivers experienced anxiety, fear, uncertainty and stress generally more than patients. The main critical elements were the poor collaboration with other territorial services and the lack of clear provisions and support from the competent authorities.
The TCs seem to have been a valid tool to contain the spread of the infection and the exacerbation of already compromised clinical pictures. The operational tools and personal resources deployed by the operators have made it possible to effectively manage the patients' emotional experiences. It seems desirable to give continuity to research and monitoring actions of the practices experimented in the TCs, with the aim of identifying possible improvement actions and creating a shared knowledge among the actors of the sector.
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