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HEALTH

‘Psychologist bonus’: Italy offers €600 discount on mental health services

Italy on Monday opened up applications for funding towards the cost of therapy amid an unprecedented mental health crisis primarily affecting young people.

‘Psychologist bonus’: Italy offers €600 discount on mental health services
The pandemic has triggered an unprecedented demand for mental health care services. Photo by JEFF PACHOUD / AFP

Italy’s residents can now claim a new ‘psychologist bonus’ (bonus psicologo) intended to help people struggling with the effects of the pandemic to access mental health services.

From Monday July 25th, applications can be made via the Italian social security office (INPS) website for vouchers worth €600 per person towards the cost of treatment.

READ ALSO: How is Italy addressing its pandemic-induced mental health crisis?

With a total fund worth €10 million, the vouchers are means tested and will be available on a first-come first-served basis until October 24th.

The patient must have an Isee (a calculation of relative household income and wealth) of under €50,000 to be eligible for the fund, which can be used when visiting professionals registered with Italy’s Albo degli psicologi (Register of Psychologists).

The funding was announced in February as part of the milleproroghe budget amendment bill, with Health Minister Roberto Speranza describing the improvement of mental health services in the country as “crucial”.

The bonus is set to be accompanied by an additional €10 million in funds aimed at strengthening existing health facilities and recruiting new mental health professionals.

The approval and implementation of the fund was welcomed by many politicians and prominent mental health experts as a step in the right direction for Italy, which is in the midst of a mental health crisis.

Some, however, were less impressed, as news outlets noted that the €10 million budget proposed for the psychologist bonus would benefit just 16,000 people; less than 0.0003 percent of Italy’s population of 59.5 million.

Italy was hit early and hard by the coronavirus pandemic, and – as in the rest of the world – people across the country have spent the last two years struggling to cope with the fallout.

There are now widespread reports of a mental health crisis in Italy affecting younger people in particular.

Recent studies show that an estimated one in four adolescents now has symptoms of clinical depression and one in five are showing signs of anxiety disorders.

In January 2021, the Bambino Gesù paediatric hospital in Rome reported a 30 percent increase in hospitalisations of children aged between 12 and 18 due to self harm after the first wave of Covid.

Meanwhile, mental health care provision in Italy varies significantly from one part of the country to another, as the healthcare system is decentralised: operating on a regional rather than a national level and administered by local health authorities (Aziende Sanitarie Locali, or Asl).

Italy’s local health authorities on average allocate just 3.2 percent to 3.3 percent of their budget to mental health, compared to upwards of 7 percent to 8.5 percent in places like Germany, France, and the UK, according to estimates made in 2020 by the Italian Society of Psychiatry.

Some Italian regions, however, are further ahead of the game than others.

In August 2020, Campania introduced a regional law granting all residents the right to be assigned a psicologo di base or ‘primary care psychologist’, the mental health equivalent of a GP, through their Asl.

Lombardy is now also set to follow Campania’s lead in establishing a network of a primary care psychologists, with Lombardy’s Regional Council reportedly voting unanimously in favour of the motion in January 2022.

See more information about claiming the ‘psychologist bonus’ on the INPS website here (in Italian) or speak to your accountant for assistance with claiming.

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COST OF LIVING

How does the cost of childcare in Italy compare to other countries?

Parents in Italy spend a monthly average of €303 for public nursery care and €324 for public kindergarten. How does that compare to other countries?

How does the cost of childcare in Italy compare to other countries?

Childcare costs in Italy can differ greatly depending on where you live, as the monthly cost of public nurseries (for children between three months and three years of age) and kindergartens (for children between three and five) are left to the discretion of local authorities.

READ ALSO: How much parental leave do you get in Italy?

According to the latest available data, a one-child Italian family spends an average of 303 euros a month for a full-time place (around ten hours a day, five days a week) at a public day nursery, or asilo nido, and an average of 324 euros a month for a place in a public kindergarten (scuola materna or scuola dell’infanzia). 

Fees are generally higher in northern regions, with the highest monthly nursery fees of all recorded at 515 euros in Lecco, Lombardy. Conversely, childcare is usually more affordable in the south – full-time nursery care in Catanzaro, Calabria costs 100 euros a month on average. 

For a breakdown of average public nursery fees by Italian region, see this website.

READ ALSO: Italy ranked among worst in Europe for tax burden on families

Unsurprisingly, fees for private daycare facilities are generally significantly higher than those for public ones. 

According to an investigation from Altroconsumo, a part-time place (five hours a day) at a private nursery costs 480 euros a month on average, whereas a full-time place (ten hours a day) can cost as much as 620 euros a month.

Once again, the available data show a big gap between the north and south of the country, with private daycare facilities in southern regions being significantly more affordable than their northern counterparts – Palermo, Sicily is the least expensive city when it comes to private nursery fees, charging an average of 2.09 euros per hour of care.

Financial support for low-income households is available in the form of a bonus asilo (‘nursery bonus’), which can be claimed by families of children in public daycare facilities or in contracted private ones.

The claimable amount depends on families’ economic situation, which in Italy is calculated as ISEE (Equivalent Financial Position Indicator). The following subsidies are in place:

  • Families with ISEE under 25,000 euros are entitled to an annual budget of 3,000 euros.
  • Families with ISEE between 25,001 euros and 40,000 euros are entitled to 2,500 euros. 
  • Families with ISEE over 40,001 euro are entitled to 1,500 euros.

The bonus asilo for the current school year must be requested by midnight on December 31st, 2022 through the INPS website.

Shortage of childcare places

While this bonus does provide vital help with childcare costs, many families are not actually able to use it due to an endemic dearth of places available at public or private daycare facilities across the country.

According to data from the Italian Public Budget Observatory (Osservatorio sui Conti Pubblici Italiani), in the school year 2019-2020 there were only 361,318 nursery places available in Italy overall (public and private nurseries were considered together in this instance).

READ ALSO: How much does it cost to raise a child in Italy?

That meant that only 26.6 percent of children eligible to receive nursery care (aged between three months and three years) could actually find a place in a daycare facility. 

Though Italy formally committed to increasing the capacity of existing nurseries and creating new facilities through its National Recovery and Resilience Plan (PNRR) – the target is to have an additional 264,480 places by December 2025 – many families are still struggling to get their children into daycare and are having to resort to alternative options.

Here’s a look at how the situation compares across Europe:

Denmark

In Denmark, every child is guaranteed a place at a public childcare facility from the age of six months. The government pays 75 percent of the cost of a place or even more if your household income is below a certain threshold

The exact amount parents pay depends on the Kommune. In Copenhagen Municipality, the cost of nursery care (vuggestue up to 2 years and 10 months) is 4,264 kroner a month including lunch (roughly €573). For kindergarten (børnehave from 2 years and 10 months to 6 years) it is 2,738 kroner a month including lunch (roughly €368).

If you have more than one child using childcare, you pay full price for the most expensive daycare and half-price for the others.

Parents in Denmark can also receive child and youth benefits (børne- og ungeydelsen), also known as børnepenge. This is a tax-free payment that you receive for each of your children until they reach the age of 18.

For children aged 0-2 years it is 4,653 kroner per quarter (roughly €156 per month per child). For children aged 3-6 years it is 3,681 kroner per quarter (roughly €123 per month per child).

Norway

The cost of nursery and kindergarten is capped at 3,050 Norwegian kroner, regardless of the hours attended or whether that facility is state-run or private. This means you’ll never pay more than roughly €295 a month per child in childcare costs.

Sweden

Generally, the highest amount parents have to pay for a full-time place in childcare is 1,572 SEK a month, which is around €145. The exact amount is calculated on income. It is half price if you have more than one child in childcare. 

Germany

The costs for daycare centres (Kindertagesstätte, or Kita for short) can differ greatly depending on where you live in Germany, as the fees are set by the local government.

In Schleswig-Holstein in the far north, parents pay on average nine percent of their after-tax income on childcare costs. In Hamburg, 4.4 percent of parent’s income goes on childcare as every child is entitled to five hours of free care a day. In Berlin, daycare is completely free. 

Spain

Costs can vary depending on whether it is a  private or public guardería or centro infantil (as nurseries are called in Spanish).

Public ones are heavily subsidised by the government and cost around €100-260 per month, depending on where you live in Spain and your situation. Private nurseries cost between €150 and €580 per month. There is also a fixed yearly fee called a matrícula or enrolment fee, which is around €100.

There is a 50 percent discount for large families and single parents don’t have to pay anything for childcare.

There’s also a deduction of up to €1,000 (cheque guardería) that is applied to the income tax return and works out at around €100 to €160 per month which is aimed at working mothers and is available up until the child is three years old.

France

In France, crèches tend to be the most affordable option and the cost is based on the family’s income. High earners might pay up to a maximum of €4.20 an hour (€33.60 for an 8-hour day), whereas low-income families might pay €0.26 an hour (€2.08 for an 8-hour day) at a crèche collective, which is for three months to three year olds. At the age of three, compulsory education begins in France.

The cost of a childminder is around €10.88 an hour and up to 50 percent of the costs of a nanny or professional childminder can be reimbursed by the government.

The OECD calculations on the percentage of income spent on childcare – based on two parents both working full time – is 13 percent in France. This is roughly similar to Spain and Italy.

Austria

Public nurseries and kindergartens are heavily subsidised and in some cases free, depending on where you live. For example in Vienna, parents only need to pay €72.33 a month to cover meal costs, with low income families being exempt from that fee.

Vienna also subsidises private kindergartens, paying up to €635.44 a month directly to the institution. 

In other provinces, kindergarten is free for part-time hours. It is mandatory for all children in Austria to attend part-time kindergarten from the age of five. They start school aged six.

Switzerland

The average Swiss family spends a massive 41 percent of their net income on childcare, three times the OECD average of 13 percent.

The average cost of childcare in Switzerland is CHF130 a day (€136). Due to tax breaks and subsidies paid out in the cantons, many parents will pay between 30 and 80 percent of this cost, depending on income. This equates to paying between €41 and €108 a day, roughly €902 to €2,376 a month. 

It’s even more expensive to hire a nannie, which will cost between CHF3,500 (€3,678) and CHF5,000 (€5,255) a month, including mandatory pension contributions.

United Kingdom

According to charity Coram in their Childcare Survey 2022, the average cost of full-time nursery is £1,166 (around €1,304 a month), which is even higher in some parts of London. There are some government subsidies available for low-income families and those receiving benefits and every parent is entitled to 15 or 30 free hours of childcare the term after their child turns three years old.

Conclusion

The cost of childcare varies within each country, depending on family circumstances. However, for guaranteed low childcare costs for every parent, Sweden comes out best, with a maximum of €145 a month.

Average monthly cost of state-run childcare:

Sweden: €145 maximum

Norway: €295 maximum

Austria: €72.33 – roughly €500

Spain: €100 – €260 

Germany: €0 –  €368

Italy: €303 for nursery care; €324 for kindergarten

Denmark: €368 – €573

France: €45,76 – €739.20 

Switzerland: €902 – €2,376 

U.K. €1,304 which reduces the term after the child turns three.

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