[Personal Health Budget as a modulator in the mobilization of primary social networks: the Lombardy Region's experiment at the ASST Santi Paolo e Carlo in Milan.]

Abstract

Purpose: This study evaluates how interventions based on Personal Health Budget (PHB), a social and health integration tool for users with complex needs, contribute to the modulation and expansion of social networks in patients with severe mental disorders, counteracting social isolation associated with unfavorable prognostic outcomes.

Methods: The prospective observational study enrolled 24 subjects diagnosed with severe mental disorder, who were included in the PHB to prevent institutionalization. The sample included patients discharged from a protected community and users from their homes referred by local services. Social networks were assessed using a custom-designed questionnaire, derived from validated instruments, to quantitatively measure network size combined with Todd's Map. Assessments were conducted at baseline, 3 months, 6 months.

Results: An increase in the size of participants' social networks and in the frequency of both phone and face-to-face contacts was observed, particularly within the local community and in relationships with community peers, cohabitants, and work colleagues. The increase was found in over 49% of cases, at both 3 and 6 months. No statistically significant differences were observed across subgroup of origin.

Discussion and conclusions: The results of the study suggest that PHB is an effective intervention model for expanding and diversifying the social networks of individuals with severe mental disorders. The tailored approach and integration and collaboration with the community and the third sector were crucial in promoting inclusion and recovery processes. Longitudinal studies with larger samples are needed to confirm the stability of these effects over time.