Campania, living wills: last in Italy. Mental health spending is below the national average.

Campania is at the bottom of the national rankings for the prevalence of living wills and its mental health spending is less than half the Italian average. This is the picture painted by the Luca Coscioni Association, which has collected data, stories, and legal initiatives on the status of certain fundamental rights in the region.

The report was presented ahead of the association's 23rd congress, "The Courage of Freedom," and addresses a variety of topics: from end-of-life issues to medically assisted procreation, from accessibility for people with disabilities to mental health, including abortion, prison conditions, and the availability of public data.

Campania ranks last among Italian regions in terms of the prevalence of advance directives. The ratio is one for every 276 inhabitants, compared to the national average of one for every 165 and one for every 217 considering only the southern regions.

The situation is critical even in the provincial capitals. Caserta records one DAT for every 749 inhabitants, Benevento one for every 729, and Naples one for every 541. In the Northeast, however, the ratio drops to one DAT for every 133 residents.

On the issue of medically assisted reproduction, the association recalls the national campaign "ART for All," supported by a petition that reached 40 signatures. The goal is "to overcome discrimination in access to medically assisted reproduction and to ensure the opportunity for single women and same-sex couples to build a family without discrimination."

Among the stories cited is that of Barbara Zoina, originally from Avellino and living in Trieste, who, after choosing single motherhood, had to undertake seven trips abroad, including Denmark, Belgium, and Spain. In 2019, after three years and a total expense of between €20 and €25, she finally had a daughter in Spain.

Another issue concerns accessibility. The Luca Coscioni Association has filed five lawsuits and formal notices to make several Campanian tourist sites accessible, including the Gardens of Augustus, the Belvedere della Migliere, the Certosa di San Giacomo, the Damecuta excavations, and the Campi Flegrei Park.

The interventions have restored full accessibility, while work is still ongoing at Damecuta. The Municipality of Capri has also been ordered to adopt the PEBA (Plan for the Elimination of Architectural Barriers).

However, the monitoring reveals a still uneven situation across the rest of the region. In Avellino and Caserta, the PEBA is currently being developed; in Benevento and Salerno, it has been adopted but still needs to be approved by their respective city councils. In Naples, however, no information is available, and a request for access to documents has remained unanswered.

In 2026, the Court of Naples also recognized Christian Durso, who suffers from SMA, the right to the prescribed electric vertical wheelchair, placing the entire cost on the ASL Napoli 1 Centro.

Regarding mental health, approximately 55 users were served by local services in Campania in 2024. However, resources, according to the report, remain insufficient: regional spending was approximately €36 per capita, compared to the Italian average of €75,2, and less than 2% of regional healthcare spending, compared to a target of 5%.

The shortage is also evident in the availability of facilities: in Naples, there are 16 mental health beds, compared to the 90 indicated as a reference.

The data on adolescents is particularly sensitive. In 2025, 9,7% of young people living in Campania experienced mental distress, placing the region among those with the highest rates in Italy.