Child and adolescent Liaison-Consultation Psychiatry and Psychosomatic Medicine in a Clinical-Teaching Hospital. / Psiquiatría de Enlace y Medicina Psicosomática Infanto Juvenil en un Hospital Clínico-Docente.

Psychosomatic medicine explores the psychological, behavioral, and social elements that influence people's health and quality of life. This discipline develops skills and knowledge used in the evalua tion and management of psychosocial elements interfering in the process of illness and healing. The Child and Adolescent Consultation-Liaison Psychiatry (CACLP) is a discipline that has been empi rically installed in order to favor adherence to treatments and recovery of children and teenagers du ring the process of illness. There is a need for developing this discipline in Chile, but so far there are limited national and international records and literature dedicated to it. The objective of this article is to update the concepts of structure and describe how a CACLP unit in a high complexity teaching hospital works in general, discussing the clinical challenges involved in these issues.

E-mental health in child psychiatry during COVID-19: an initial attitudinal study.

OBJECTIVE: COVID-19 propelled e-mental health within the Australian health system. It is important to learn from this to inform mental healthcare during future crises. METHOD: A lexical analysis was conducted of clinician reflections during COVID-19 as they delivered psychiatry services to children and families in New South Wales (n = 6) and transitioned to e-mental health. RESULTS: E-mental health can extend the reach of, and access to psychiatry services, particularly for individuals disadvantaged by inequity. Yet e-mental health can be problematic. It is partly contingent on technological prowess, equipment, internet access as well as space and privacy. Relatedly, e-mental health can hinder clinician capacity to conduct examinations, monitor child development as well as assess risk and the need for child protection. CONCLUSIONS: Given the benefits and limitations of e-mental health, a model that supports face-to-face mental healthcare and e-mental health may be of value. This model would require practical, yet flexible policies and protocols that protect the privacy of children and families, safeguard them from harm, and respect the needs and preferences of children, families and clinicians.

[COVID-19, families and institutions put to the test in paediatric psychiatry]. / Covid-19, familles et institutions à l'épreuve en pédopsychiatrie.

The lockdown provoked by the COVID-19 pandemic has resulted in a reorganisation of the provision of care. The staff of the child psychiatry unit in Coulommiers has had to redesign the care provision in the light ofthe current constraints and requirements. New tools and methods have appeared, along with a new symptomatology which has had to be understood in its context. The health crisis has also affected the patients. Some have disappeared from view while others show signs of anxiety and panic attacks. Caregivers have managed to adapt in order to guarantee the necessary continuity of care.

[Reorganisation of the service of child and adolescent psychiatrie examplified by the domaine of perinatal psychiatrie and psychiatrie of early chidlhood]. / Réorganisation d'un service de la psychiatrie de l'enfant et de l'adolescent - Le domaine « Périnatalité et petite enfance ¼.

This article presents the construction of a chain of care of perinatal psychiatric situations within the University Service of Child and Adolescent Psychiatry, which evolved within the framework of the departmentalization of this service. This chain of care includes the psychiatry of the liaison, the outpatient clinics as well as and day hospital care and extends from the prenatal period to the child's five years, with a focus on the relationship between child and caregivers, as well as an individual perspective on the child. Herein, we present and describe the different units and their functioning emphasizing the synergies and collaborations put in place that ensure the best possible continuity for patients and their families by promoting as much as possible the therapeutic alliance in this chain of care.

Cet article présente la mise en place d'une filière de soins pour la prise en charge des situations de psychiatrie périnatale au sein du Service universitaire de psychiatrie de l'enfant et de l'adolescent, qui prend place dans le cadre de la départementalisation de ce service. Cette filière de soins comprend des prises en charge de liaison, en ambulatoire et en hôpital de jour, et s'étend de la période prénatale aux 5 ans de l'enfant, en se focalisant sur les aspects relationnels parents-bébé mais également sur l'enfant en tant qu'individu. Les différents lieux de prise en charge sont présentés et chacun de leur mode de fonctionnement est décrit. Cet article insiste sur l'importance capitale d'une articulation et d'une collaboration étroite entre les différents lieux de prise en charge afin d'assurer la meilleure continuité possible des soins pour les patients et leur famille en favorisant au maximum l'alliance thérapeutique.

Historia de la Asociación Española de Psiquiatría del Niño y del Adolescente (AEPNyA) en su setenta aniversario / History of the Spanish Association of Child and Adolescent Psychiatry on its 70th Anniversary

La Asociación española de psiquiatría del niño y del adolescente (AEPNyA) se fundó en Barcelona en el año 1950 como una sociedad médica que tenía como objetivo el estudio de los trastornos psiquiátricos de niños y adolescentes. Su desarrollo corre en paralelo con la de la psiquiatría infantil europea. Los fundadores fueron hombres y mujeres ilustrados, comprometidos con su tiempo y con la salud mental, la educación y los derechos de la infancia. Este artículo aborda los hitos principales de la historia de AEPNyA y distingue tres periodos: los comienzos, la fase de afianzamiento y el tiempo de la madurez. Los autores desean rendir un homenaje a los miembros fundadores y a todos aquellos que han contribuido al desarrollo de la Asociación

The Spanish Association of Child and Adolescent Psychiatry (AEPNyA) was founded in 1950 in Barcelona as a medical society, and was one of the first Societies for Child Psychiatry in Europe. Its founders were learned men and women who were concerned not only with children's psychiatric disorders, but also with their education and rights. The history of child psychiatry in Spain is intertwined with the development of this field throughout Europe. Over the course of its history, the AEPNyA has gone through several stages: its beginnings, its development, and its more established stage. This article pays tribute to the founders of the AEPNyA and to all those that have made a contribution to its development

Building capacity for child and adolescent mental health and psychiatry in Papua New Guinea.

OBJECTIVE: To describe the recent work of child psychiatrists in Australia, New Zealand (ANZ) and Papua New Guinea (PNG) adding to mental health capacity building across the life-span, starting with children and adolescents. METHOD: Concerns about treatment access and clinical training needs, combined with academic leadership and National Department of Health commitment, supported the collaborative involvement of the Royal Australian and New Zealand College of Psychiatry (RANZCP) in workforce development. This has been initially established under the auspices of the Faculty of Child and Adolescent Psychiatry (FCAP). RESULTS: Workforce development in child and adolescent mental health is underway, with sustainability, consolidation and scaling up of initiatives required to meet need. CONCLUSIONS: Expanding mental health workforce capacity in partnership with the National Department of Health and the University of Papua New Guinea (UPNG) seems feasible. Ongoing cooperation is required to realize the potential of such collaborative initiatives.

The Michigan Child Collaborative Care Program: Building a Telepsychiatry Consultation Service.

This column describes the establishment of the Michigan Child Collaborative Care (MC3), a statewide telepsychiatry consultation program that provides support to primary care providers (PCPs) in meeting the mental health needs of youths and perinatal women. The MC3 program provides cost-effective, timely, remote consultation to primary care providers in an effort to address the lack of access and scarcity of resources in child, adolescent, and perinatal psychiatry. Data from 10,445 service requests are summarized. Common diagnoses included attention-deficit hyperactivity disorder, mood disorders, anxiety disorders, and autistic spectrum disorders, with many cases (58%) deemed moderate to severe. Co-occurring psychological trauma was suspected in 9% of service requests. Partnerships, stakeholder roles, PCP engagement, and workflow integration are highlighted as keys to the program's success.

Collaboration, Innovation, and Time: A Shared Journey Through Child Psychiatric Consultation in the School Setting.

About 20% of students in U.S. communities have diagnoses of emotional and behavioral disturbances. Even when mental health services are in place, students and teachers often struggle in the classroom. In this column, the authors describe a partnership with a public school system to provide collaborative, innovative support that also offered a novel training opportunity for child and adolescent psychiatry fellows. Over three years of collaborative work, the child psychiatry team (attending child psychiatrist and two child psychiatry fellows) offered direct clinical care and consultation in a school-based clinic. In later years, the team provided ongoing professional development and consultation to teachers, and the model was implemented districtwide. The authors describe challenges of engaging and working in the school setting, which call on key strengths of an effective partnership: communication, respect, and trust. The multiyear partnership offered a mutually beneficial experience for both educators and psychiatry trainees.

Awareness and perceptions of clinical guidelines for the diagnostics and treatment of severe behavioural problems in children across Europe: A qualitative survey with academic experts.

BACKGROUND: Severe behavioural problems (SBPs1) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts' perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6-12 across Europe. METHODS: An online semi-structured questionnaire was completed by 28 psychiatry and psychology experts from 23 countries. RESULTS: Experts indicated that approximately two thirds of the included European countries use at least an unofficial clinical document such as textbooks, while nearly half possess official guidelines for SBPs. Experts believed that, although useful for practice, guidelines' benefits would be maximised if they included more specific recommendations and were implemented more conscientiously. Similarly, experts suggested that unofficial clinical documents offer a wide range of treatment options to individualise treatment from. However, they stressed the need for more consistent, evidence-based clinical practices, by means of developing national and European clinical guidelines for SBPs. CONCLUSIONS: This study offers a preliminary insight into the current successes and challenges perceived by experts around Europe associated with guidelines and documents for SBPs, acting as a stepping stone for future systematic, in-depth investigations of guidelines. Additionally, it establishes experts' consensus for the need to develop official guidelines better tailored to clinical practice, creating a momentum for a transition towards European clinical guidelines for this population.

Análisis de las diferencias en la atención a la Salud Mental del Niño y Adolescente en España a través de los Planes Estratégicos de Salud Mental Autonómicos / Analysis of the disparities in Mental Health care of Children and Adolescents in Spain through the Autonomic Mental Health Strategic Plans

Introduccion: La Psiquiatría Infantil es una especialidad relativamente reciente. Es un área importante de trabajo ya que los datos reflejan que la tasa de prevalencia de trastornos mentales en niños y adolescentes se sitúa entre el 15 y el 20 % de la población infanto-juvenil a nivel mundial, o que el 80 % de los trastornos mentales de los adultos tuvieron comienzo antes de los 18 años. En toda España se puede ofrecer asistencia a niños y adolescentes, aunque ésta no se encuentra homogeneizada en todas las Comunidades Autónomas (CCAA). Adicionalmente, España es uno de los dos únicos países de la Unión Europea que no dispone de la especialidad de Psiquiatría del Niño y Adolescente. Al no existir a día de hoy una especialidad propia, el carácter de la atención ofrecida dependerá de la formación particular de cada profesional. Objetivo: Analizar la situación de la atención a la Salud Mental del Niño y Adolescente en España a través de los Planes Estratégicos de Salud Mental Autonómicos. Método: Se analizaron mediante lectura exhaustiva las líneas estratégicas de los 17 Planes Estratégicos de Salud Mental de todas las CCAA. Resultados: Se han encontrado desigualdades tanto en la vigencia y actualización de dichos planes, como en la estructura y oferta de recursos asistenciales y formativos. Conclusión: Hoy en día la especificidad en la atención a la Salud Mental del niño y adolescente se distribuye de forma desigual en España, dependerá de la CCAA en la que resida el niño o adolescente

Background: Child Psychiatry is a relatively recent specialty. It is an important field of work because the data show that the prevalence rate of Mental Disorders in children and adolescents is between 15 and 20 % of the infantile-juvenile population worldwide, and that 80 % of the Mental Disorders in adults began before the age of 18. Throughout Spain, assistance can be offered to children and adolescents, although it is not standardised in all the Autonomous Communities (CCAA). In addition, Spain is one of only two countries in the European Union that does not have the specialty of Child and Adolescent Psychiatry. As there is currently no specialty of its own, the nature of the care offered will depend on the particular training of each professional. Objective: To analyse the situation of mental health care for children and adolescents in Spain through the Autonomous Mental Health Strategic Plans. Methods: The strategic lines of the 17 Strategic Mental Health Plans of all the Autonomous Communities were analysed. Results: Inequalities were found in the validity and updating of these plans, as well as in the structure and supply of assistance and training resources. Conclusion: Today, the specificity of mental health care for children and adolescents is distributed unequally in Spain, depending on the Autonomous Community in which the child or adolescent resides

Building Child and Adolescent Psychiatry Expertise in Ghana Through Training and Knowledge Dissemination: a Review of the Initial Collaboration Stages, Opportunities, and Challenges.

PURPOSE OF REVIEW: Improving child and adolescent mental health (CAMH) is a priority worldwide. The majority of children with psychiatric conditions in low-middle-income countries (LMIC), like Ghana, receive no treatment due largely to limited resources and few CAMH training opportunities. The Komfo Anokye Teaching Hospital (KATH) and University of Michigan (UM) established a partnership to expand CAMH training for general psychiatrists in Ghana. Lessons learned from the early stages of the collaboration can serve as an adaptable roadmap for similar efforts to expand CAMH training in LMIC. RECENT FINDINGS: Previous articles have discussed global academic partnership, training, and capacity building programs; however, early challenges, opportunities, and preparatory stages involved in creating a mutually beneficial collaboration aimed at improving child psychiatry expertise in a LMIC are under explored in the global mental health literature. This article seeks to fill that gap by using examples to highlight unique considerations for institutions in the initial stages of establishing their global partnership. The early stages of a global partnership can impact the success of the collaboration. Collaborations should be bi-directional, sensitive to local culture, and flexible and establish achievable sustainable goals.

[Psychodynamics in organisation and cooperation of child and adolescents institutions]. / Zur Psychodynamik von Organisation und Kooperation in der Kinder- und Jugendpsychiatrie.

According to underlying law (Krankenanstaltengesetz) the internal structure of Departments of Child and Adolescent Psychiatry (CAP) represents a matrix structure, defining formal roles and tasks of the personel. In contrast, external cooperation is defined in several different laws. Furthermore, patients and their systems are exhibiting a high tensional potential. These different influences can cause more or less severe enmeshments. Thus, during the treatment of this patients it is necessary to take into account the possibility of these enmeshments. It should be answered by special forms of care of the relationship between professionals and families. These special forms of relational care can be delivered by clear organizational structures and must undergo reflective processes on a regular basis. The planning and delivery of those structures is clearly seen as a central responsibility of the management of a CAP-Department.

Massachusetts Child Psychiatry Access Project 2.0: A Case Study in Child Psychiatry Access Program Redesign.

The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign. The redesign process is described, moving from an initial strategic assessment of program and the planning of structural and functional changes, through transition and implementation.