CERGAS Seminar "Intersectoral integration of mental-health and psychosocial-support services for children and adolescents: lessons from a UNICEF project in Italy"

This study is the Italian component of the multi-country project Child & Youth Wellbeing and Mental Health First (REFORM/IM2023/025), implemented by UNICEF in cooperation with the European Commission through the Technical Support Instrument. The study examines the current state of cooperation among stakeholders providing mental-health and psychosocial-support (MHPSS) services for children and adolescents in Italy, offering an integrated analysis of governance frameworks, regional implementation models and collaborative practices. 
Anchored in the Rainbow Model of Integrated Care, the project conceptualises integration across micro (clinical), meso (professional and organisational) and macro (system) levels, exploring how relational coordination can strengthen cross-sectoral service delivery. A systematic international desk review of eighteen peer-reviewed publications encompassing 335 primary studies identified successful models of integrated youth-centred and community-based care. These insights informed a multi-regional assessment of Italian MHPSS systems, combining documentary analysis of regional health and mental-health plans with in-depth interviews, structured consultations with district-level stakeholders, and five case-studies of relevant practices that illustrate real-world barriers and enablers for successful integration. 
Findings reveal substantial regional disparities in access, coordination and workforce resources. While multidisciplinary teams, typically comprising child neuropsychiatrists, psychologists, social workers and educators, operate across most territories, few regions maintain permanent or formalised coordination mechanisms among health, education and social sectors. Systemic challenges include professional shortages, long waiting lists and uneven financing models, despite targeted investments through the National Recovery and Resilience Plan and European Structural Funds. The comparative analysis of the five cases further shows that integration alone does not ensure equity: equity emerges as an organisational property produced by aligning access design, youth participation, digital governance and institutional anchoring across micro, meso and macro levels, with trust and participation requiring formal governance and institutional embedding to be sustained. The project represents a shift from transactional coordination towards distributed, human-centred governance. It aligns with relational public management emphasis on learning systems and participatory inquiry, positioning integration as a relational capability that depends on reflexive communication, shared accountability and mutual trust. By integrating the analytical rigour of health-system research with the human-centred ethos of relational public management, the project offers a novel framework for understanding and improving MHPSS adolescent service integration in Italy, one that values cooperation as both a policy instrument and a relational practice essential to sustainable wellbeing.

Speakers:

Viviana Mangiaterra is a SDA Associate Professor of Practice in Health Policy since 2020. She is the Director of the Masters in International Health Management, Economics and Policy (MIHMEP) and director of several SDA Bocconi executive courses like 'Access to Medicines in LMICs' and 'Hospital management simulation course'. She is also coordinating the stream of Global Health within the framework of research carried out by CERGAS which includes: i) an evaluation study on eLIMS/EIR systems in 4 LMICs (Gates grant); ii) the cost-effective analysis in research on Quality Improvement of Integrated HIV, TB and Malaria in Antenatal and Postnatal care in three African countries (in collaboration with the Liverpool School of Tropical Medicine).
Viviana had global career in international public health. The main focus of her work has been on strategic planning; policy development; health system strengthening; technical advice for program implementation in the field of reproductive, maternal, child and adolescent health, gender, HIV and malaria; and partnership-building with a wide range of stakeholders. She has gained broad operational research experience in public healthcare in developing countries.
She has carried out several research projects in key areas of public health. For the Global Fund to Fight AIDS, Tuberculosis and Malaria, she has led ongoing 3-year multi-country quality improvement operational research on the integration of HIV, TB and malaria services in antenatal care using a standards based assessment methodology. Her research aims to assess the effectiveness and efficiency of integrated service delivery on outcomes and impact for these three diseases in mothers and newborns.
For the World Health Organization (WHO) she has led many research projects including the operational research of the Reproductive Health and Research Team on Essential Medicines with a main focus on pre-qualification and regulatory aspects of female condoms and emergency contraception; a major research initiative, including study design, questionnaire development, surveyor training, data collection and analysis of a new methodology developed by the London School of Tropical Medicine, for an under five mortality household survey in seven provinces of Indonesia; various research protocols for the study of vitamin A and iodine deficiency disorders in Rwanda.
She has had a long and significant professional career in the global public health arena. She has worked in several leading international organizations at all levels – headquarters, regional and county-based – including the World Health Organization, the World Bank and currently the Global Fund to Fight HIV, Tuberculosis and Malaria. Through this experience, she has developed proven leadership skills in building strong partnerships with internal and external stakeholders, as well as significant knowledge of working with funding mechanisms of major partner organizations engaged in global public health. As such, she has established a broad network of contacts with stakeholders in the public and private sectors. In her country-based work in Rwanda, Indonesia, Moldova, Sudan, Egypt, the Central Asian Republics and the Caucasus, she has directly influenced policies and the allocation of resources, provided high-quality technical advice, supported national capacity building and the strengthening of health systems, guided evaluation processes and performed operational research. She has successfully led teams with a proven track record for delivering results and success in providing resources for the identified priorities and scope of work.
She has been a visiting professor in SDA Bocconi’s Master in International Health Management, Economics and Policy (MIHMEP), she has also gained teaching experience at the Johns Hopkins, School of Advanced International Studies, co-teaching the course on Health Problems, Policies and Practices in Developing Countries. She has also taught at Butare University in Rwanda.
She earned a degree in Medicine and Surgery from the Università di Milano; a Master in Pediatrics and a Master in Gastroenterology, also from the Università di Milano, with residential research in child nutrition in Brussels (Hôpital St. Pierre) and Paris (Hôpital des Enfants malades) and a Diploma in International Epidemiology at the Center for Disease Control, Atlanta USA.

Elisabetta Trinchero is an Associate Professor of Practice in Public Management at SDA Bocconi School of Management.
At SDA Bocconi she has taught in the Healthcare Management Master (MiMS), the Public Management Master, and the Sport Management Master (FIFA) since 1995. She has conducted research and education projects for major public and private organizations.
Her research activities focus on strategic crisis management, risk and sustainability management in public service organizations.
She is the author of numerous books and articles on her research subjects. Her works have been published in Plos One, Public Management Review, Public Money & Management, Economia & Management, and Mecosan, among others. An AMARIS researcher, she collaborates with Southern Cross University. Since 2012, she has presented yearly research papers at the annual AOM and IRSPM conferences. She won the best paper award on Public Management and Governance at the 2016 British Academy of Management annual conference.
Elisabetta earned a Ph.D. at Southern Cross University, a 4 year degree in Economics, and a second level Specialized Master at Università Bocconi.

Oriana Ciani is an Associate Professor of Practice in the Public Management and Policy, Health Economics, and HTA (Health Technology Assessment) Area at SDA Bocconi School of Management.
Her collaboration with SDA began in 2010. She coordinates the Epidemiology and Public Health module in the "Master of International Health Care Management, Economics and Politics" (MIHMEP) and teaches in numerous training courses for healthcare professionals on health economics and economic evaluation of healthcare interventions.
Her research interests focus on the use of Health Technology Assessment (HTA) in healthcare decision-making processes, methodological aspects of health technology assessments, particularly in the field of medical devices and digital technologies, evidence synthesis to inform policy choices. Oriana earned her PhD from the University of Exeter Medical School (UK) with a thesis on the validation of surrogate outcomes, which remains one of her main areas of interest.
She has participated in numerous national and international research projects, involving various partners, such as MedTecHTA (FP7 no. 305694), Mapping NCD (FP7 no. 602536), and COMED (H2020 no.779306). Since 2023, she has been the coordinator of the three-year HORIZON Europe project HI-PRIX (no. 101095593), focusing on innovative pricing and payment schemes for healthcare technologies.
In 2020, Oriana was a Fulbright Research Scholar at the Yale School of Medicine and the Yale School of Public Health. She serves as an Associate Editor of Value in Health and is the author of numerous internationally recognized publications. Her study published in the International Journal of Health Technology Assessment (2015) on HTA systems for medical devices received the Egon Jonsson Award in 2016. For her research activities, she has received other awards, including the Bocconi Research Award (2023), the Exeter Impact Award (2013), the Best Student Podium Presentation Award at the ISPOR Conference in Dublin (2013), and the young researchers award from AIES (2010).
Oriana holds a bachelor's and master's degree in Biomedical Engineering from the Polytechnic University of Milan and a Master's in Healthcare Management from SDA Bocconi.

Link zoom:

https://unibocconi-it.zoom.us/j/96946874196?pwd=KWbYqdk4gn1kpyobZUDCALynoKqF9N.1

Meeting ID:

969 4687 4196

Passcode:

749161

Lunch at the end of the meeting: for those willing to participate in person, click here before the 23rd of October.