In May 2023, Emilia-Romagna experienced catastrophic flooding that affected 100 municipalities, displaced 36,600 people, and caused 17 fatalities. For the first time in Italy, a structured regional mental health support system was activated, coordinating three Civil Protection volunteer associations: Società Italiana Psicologia dell'Emergenza Emilia-Romagna, Psicologi per i popoli Emilia-Romagna, and the Italian Red Cross. The intervention provided psychological first aid, crisis intervention, and psychosocial support to affected populations using proximity-based approaches, reaching victims directly in affected neighborhoods, shelters, and community centers.
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Mental Health Support for Flooded Populations
General Information
A coordinated mental health support system after Emilia Romagna's flood
The May 2023 floods resulted from six months' worth of rain falling in 20 days, causing widespread devastation, including 60,000 landslides, 23 river overflows, and damages estimated at 8.6 billion Euros. The catastrophic event created immediate psychological trauma and stress among the population, with many losing homes, possessions, and livelihoods. The Emergency Psychology Working Group of the Emilia-Romagna Order of Psychologists, established in 2021, had prepared the groundwork for coordinated psychological emergency response, enabling rapid deployment when the disaster struck.
Needs Addressed
The floods created widespread psychological trauma and stress among affected populations. People experienced loss of homes, possessions, and sense of security. There was an immediate need for psychological support to help victims cope with acute stress, prevent long-term psychological consequences, and support community resilience. Additionally, emergency responders and local leaders needed psychological support to maintain their effectiveness during the crisis
The elderly population was particularly affected, as Emilia-Romagna has a high prevalence of elderly residents with chronic conditions. Children required specialized psychological support to process the traumatic events. People with disabilities faced additional challenges during evacuations and in accessing support services. Special attention was given to those who had experienced previous traumas that could be reactivated by the flood events.
The response involved coordination between multiple levels: national Civil Protection activation, regional coordination by Emilia-Romagna authorities, and local implementation through Municipal Operations Centers. The Emergency Psychology Working Group facilitated coordination among volunteer associations, health authorities, and municipalities. Daily online board meetings ensured effective multi-stakeholder collaboration.
The region had established the Emergency Psychology Working Group in 2021, creating protocols and training frameworks for psychological emergency response. Three Civil Protection volunteer associations had trained emergency psychologists with personal protective equipment and field authorization. However, this was the first large-scale implementation of the coordinated system.
The region had 128 operational community health centers (25.6% of all such facilities in Italy), providing a strong foundation for integrated health and social services. The Civil Protection system was well-established with clear activation protocols and coordination mechanisms. However, the unprecedented scale of flooding severely damaged physical infrastructure in many areas.
To provide immediate psychological support to disaster-affected populations, coordinate volunteer efforts, ensure continuity of mental health services, build community resilience, and prevent long-term psychological consequences through early intervention and community-based approaches.
Proximity interventions in affected neighborhoods, psychological first aid in shelters and community centers, Critical Incident Stress Management (CISM) groups, psychoeducational meetings, individual support sessions, support for local mayors and officials, daily coordination meetings, community outreach in parishes and schools.
Communities actively participated in identifying needs and accessing services. Local mayors, as heads of municipal Civil Protection, were supported to make informed decisions and communicate effectively with citizens. Volunteer associations had autonomy in implementing interventions while coordinating through daily meetings. Affected populations could access services voluntarily and shape the type of support received.
The intervention included psychoeducational components teaching communities about normal reactions to disasters and coping strategies. The experience strengthened the regional emergency psychology system for future events. Training and coordination mechanisms developed during the response enhanced long-term disaster preparedness. Community-based approaches built local capacity for mutual support and resilience.
Hazard Type
Geographical Scope - Nuts
Population Size
Population Density
Vulnerable Groups
Governance
Emergency Preparedness
Infrastructure Readiness
Engagement Level
Empowerment Level
Implementation
First structured regional psychological emergency response system in Italy; Proximity-based approach following PIES model (Proximity, Immediacy, Expectancy, Simplicity); Integration of volunteer associations with official health system; Continuous support from acute phase through 6-month follow-up; Multi-level intervention targeting individuals, groups, and institutions; Daily coordination meetings ensuring unified response; Direct support to community leaders to enhance crisis communication.
Italian
Società Italiana Psicologia dell'Emergenza Emilia-Romagna, Psicologi per i popoli Emilia-Romagna, Italian Red Cross, Emergency Psychology Working Group of the Emilia-Romagna Order of Psychologists.
All implementing organizations are registered Civil Protection volunteer associations with extensive training in emergency psychology. Members are certified emergency psychologists with specific protocols for disaster intervention. The Emergency Psychology Working Group was established in 2021 specifically to develop regional capacity for psychological emergency response. Organizations follow international guidelines including IASC and WHO protocols.
Civil Protection (national and regional), Emergency psychology volunteer associations, Order of Psychologists, Local health authorities (AUSL), Municipal authorities and mayors, Italian Red Cross, Police forces, Community organizations (parishes, schools), International support (EU Civil Protection Mechanism).
- Immediate activation following Civil Protection alert (May 3-4, 2023)
- Deployment of emergency psychologists to affected areas
- Establishment of daily coordination meetings, Implementation of proximity interventions in neighbourhoods and shelters
- Provision of psychological first aid and CISM groups
- Support to mayors and institutional communication
- Continuous monitoring and daily reporting
- Follow-up services for 6 months post-event
- Evaluation and system strengthening
- Human resources: 7 volunteer psychologists per day from May 17 to June 22, 2023, plus additional volunteers from across Italy
- Technical resources: personal protective equipment, communication tools, transportation to reach affected areas
- Coordination resources: online meeting platforms, reporting systems
- Financial resources: volunteer mobilization costs, equipment, logistics support from Civil Protection funding
- Immediate response phase: May 3-22, 2023 (peak emergency)
- Sustained intervention phase: May 23 - June 22, 2023 (continued field presence)
- Follow-up phase: June 2023 - November 2023 (6-month monitoring and support)
- Evaluation and strengthening phase: Ongoing system improvements based on lessons learned
Experience of the Implementing Organisation in DRM
Target Audience
Resources Required
Timeframe & Phases
Participation Results
- Importance of pre-established coordination mechanisms and protocols
- Value of proximity-based approaches in building trust and accessibility
- Need for supporting institutional leaders (mayors) to enhance crisis communication
- Effectiveness of integrating volunteer associations with official health systems
- Critical role of daily coordination in managing complex multi-stakeholder responses
- Importance of planning for extended follow-up beyond the acute phase
- Challenge: Coordinating multiple volunteer associations and ensuring coverage across vast affected areas. Strategy: Daily online coordination meetings and unified reporting system.
- Challenge: Reaching isolated populations in severely damaged areas. Strategy: Proximity approach with psychologists going directly to affected neighborhoods.
- Challenge: Managing spontaneous volunteers while maintaining quality standards. Strategy: Deployment only of certified emergency psychologists with proper training and PPE.
- Risk of volunteer burnout: rotation system limiting deployment periods
- Risk of retraumatization: use of evidence-based protocols and supervision
- Risk of coordination failures: daily meetings and clear reporting lines
- Risk of inadequate coverage: mobilization of volunteers from across Italy
- Risk of service discontinuity: 6-month follow-up plan integrated with local health services
Risk & Mitigation Plan
Scalability and Sustainability
The model builds on existing Civil Protection volunteer structures with established funding mechanisms. The Emergency Psychology Working Group provides ongoing coordination and protocol development. Integration with regional health authorities ensures continuity of services. Training programs maintain qualified volunteer pools. Experience from this event strengthens preparedness for future disasters.
The model is highly scalable as it builds on Italy's national Civil Protection system present in all regions. The protocols follow international guidelines (IASC, WHO) making them adaptable to different contexts. The approach can be modified for different disaster types while maintaining core principles. Other regions can establish similar emergency psychology working groups and volunteer certification systems.
Technology played a supporting role through online coordination meetings, enabling daily multi-stakeholder collaboration despite physical distances. Digital reporting systems facilitated real-time monitoring of interventions and needs. However, the core intervention remained human-centered with direct interpersonal contact as the primary mode of support delivery.
Information on direct costs is not available.
Information on operational costs is not available.