[The first access to Mental Health Services in a multi-ethnic city: diagnostic and therapeutic differences in the population of Prato, Italy.]

Aim: In urban contexts, Mental Health Services are increasingly involved in the assessment of users with a heterogeneous ethnic and cultural background. These characteristics of migrants can exert an influence on access to healthcare, diagnostic evaluation, and use of therapeutic resources. The present work aimed to compare these differences among individuals who received their first clinical evaluation at the Mental Health Outpatient Service of Prato in 2019-2021, exploring variations across time, among the entire non-native population, and based on their continent of origin.

Methods: In the abovementioned clinical population, socio-demographic data, the type of evaluation received, and the primary diagnostic classification were retrieved. Their absolute and relative frequencies were registered, and differences based on the origin of migrants were explored.

Results: Of 3,992 assessments, 485 (12.1%) involved non-natives from 60 different countries, with a lower mean age as compared to the Italian counterpart, and a heterogeneous gender prevalence based on the continent of origin. The percentage of migrants increased from 11.8% to 14.2% across time, with a higher proportion of psychiatric evaluations and a lower implementation of multi-professional interventions. As compared to native individuals, a higher proportion of adjustment, psychotic, substance-related, somatic, conversive, dissociative, and post-traumatic disorders was observed.

Discussion and conclusions: The access of migrants to the Public Mental Health outpatient facility proved to be remarkably lower than expected, based on the composition of the general population. Given the proportional increase in the requested evaluations, it is necessary to promote a reflexion on the specificity of the emergent psychopathology, and on difficulties in access to psychotherapy: a trans-cultural approach to mental health may require adequate resources for the management of these distinctive needs.