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1.
Psychiatr Serv ; 70(7): 631-634, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31109265

RESUMO

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.


Assuntos
Sintomas Comportamentais/terapia , Psiquiatria Infantil , Colaboração Intersetorial , Transtornos Mentais/terapia , Serviços de Saúde Mental , Parcerias Público-Privadas , Encaminhamento e Consulta , Instituições Acadêmicas , Criança , Psiquiatria Infantil/educação , Psiquiatria Infantil/organização & administração , Humanos , Serviços de Saúde Mental/organização & administração , Parcerias Público-Privadas/organização & administração , Encaminhamento e Consulta/organização & administração , Professores Escolares , Instituições Acadêmicas/organização & administração , Estudantes
2.
Eur Psychiatry ; 57: 1-9, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30658274

RESUMO

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.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Psiquiatria Infantil/organização & administração , Pediatria/organização & administração , Comportamento Problema , Conscientização , Criança , Comportamento Infantil/fisiologia , Europa (Continente) , Humanos , Guias de Prática Clínica como Assunto , Prevalência
3.
Rev. psiquiatr. infanto-juv ; 36(1): 20-30, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184297

RESUMO

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


Assuntos
Humanos , Criança , Adolescente , Saúde Mental , Planejamento de Assistência ao Paciente/organização & administração , Psiquiatria do Adolescente/organização & administração , Psiquiatria Infantil/organização & administração , Nível de Saúde , Psiquiatria do Adolescente/normas , Disparidades em Assistência à Saúde
4.
Curr Psychiatry Rep ; 20(11): 105, 2018 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-30259208

RESUMO

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.


Assuntos
Psiquiatria do Adolescente/educação , Psiquiatria do Adolescente/organização & administração , Psiquiatria Infantil/educação , Psiquiatria Infantil/organização & administração , Adolescente , Psiquiatria do Adolescente/tendências , Fortalecimento Institucional , Criança , Psiquiatria Infantil/tendências , Gana , Saúde Global , Hospitais de Ensino , Humanos , Saúde Mental/educação , Saúde Mental/tendências
8.
Child Adolesc Psychiatr Clin N Am ; 26(4): 647-663, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28916005

RESUMO

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.


Assuntos
Psiquiatria Infantil/organização & administração , Prestação Integrada de Cuidados de Saúde/métodos , Serviços de Saúde Mental/organização & administração , Estudos de Casos Organizacionais , Criança , Humanos , Massachusetts , Atenção Primária à Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Encaminhamento e Consulta
9.
Child Adolesc Psychiatr Clin N Am ; 26(4): 677-688, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28916007

RESUMO

Integrated health care models attempt to cross the barrier between behavioral and medical worlds in order to improve access to quality care that meets the needs of the whole patient. Unfortunately, the integration of behavioral health and physical health providers in one space is not enough to actually promote integration. There are many models for promoting integration and collaboration within the primary care context. This article uses the experience of the Children's Community Pediatrics Behavioral Health Services system to highlight components of collaboration that should be considered in order to successfully integrate behavioral health within a medical home.


Assuntos
Psiquiatria Infantil/organização & administração , Serviços Comunitários de Saúde Mental/organização & administração , Prestação Integrada de Cuidados de Saúde , Pessoal de Saúde/psicologia , Pediatria/organização & administração , Criança , Humanos , Estudos de Casos Organizacionais
10.
Neuropsychiatr ; 31(3): 121-126, 2017 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-28887619

RESUMO

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.


Assuntos
Psiquiatria do Adolescente/organização & administração , Psiquiatria Infantil/organização & administração , Comunicação Interdisciplinar , Colaboração Intersetorial , Relações Profissional-Família , Unidade Hospitalar de Psiquiatria/organização & administração , Teoria de Sistemas , Adolescente , Áustria , Criança , Assistência à Saúde/organização & administração , Processos Grupais , Humanos , Relações Interinstitucionais , Negociação
11.
Neuropsychiatr ; 31(3): 103-111, 2017 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-28853027

RESUMO

We discuss the comprehensive work for the development of child and adolescent psychiatry in Austria, summarize the current status of care in various settings and focus on further developments. Intramural care offers about 50% of the places needed and is heterogeneously distributed over the country, extramural care offers already around one quarter of care in need. We calculated a fully developed extramural care system from about 2033. Further development of the Austrian care system in child and adolescent psychiatry needs collaborative efforts of all responsible players.


Assuntos
Psiquiatria do Adolescente/tendências , Psiquiatria Infantil/tendências , Programas Nacionais de Saúde/tendências , Prática de Saúde Pública , Especialização/tendências , Adolescente , Psiquiatria do Adolescente/organização & administração , Assistência Ambulatorial/organização & administração , Assistência Ambulatorial/tendências , Áustria , Criança , Psiquiatria Infantil/organização & administração , Previsões , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Programas Nacionais de Saúde/organização & administração
12.
Neuropsychiatr ; 31(3): 144-149, 2017 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-28853042

RESUMO

Anniversaries are turningpoints for reflexions of the past and planing for the future. In conclusion of all papers in this actual issue one can say tha CAP has reached a respected place in the medical landscape. Also internationally, the work of Austrian child and adolescent psychiatrist is recognised and respected. CAP is cooperating as an respected discipline with adjacent specialties as pediatrics and psychiatry as well as with external partners as Kinder- und Jugendhilfe (social child welfare).Anyway, the actual situation shows several deficits concerning patient care on all levels of the health system as well as in education and training of sufficient numbers of child and adolescent psychiatrists.


Assuntos
Psiquiatria do Adolescente/organização & administração , Psiquiatria do Adolescente/tendências , Psiquiatria Infantil/organização & administração , Psiquiatria Infantil/tendências , Adolescente , Áustria , Criança , Previsões , Humanos
13.
Acad Psychiatry ; 41(5): 582-586, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28707231

RESUMO

OBJECTIVE: This report examines the experience of one institution's development of the first student-run psychiatry clinic that serves both adult and pediatric populations. METHODS: The clinic is held weekly with pre-clinical and clinical medical student volunteers under the supervision of board-certified adult and child psychiatrists. The development and evolution of the clinic over time are evaluated with particular attention to obstacles overcome. Medical student volunteers were surveyed retrospectively to evaluate their experience with patients with psychiatric illness, skill development, and interest in psychiatry. RESULTS: Since January 2016, the clinic has scheduled 90 patients, 32% of which were pediatric patients. Ninety-six medical students have volunteered, with roughly equal parts from all four medical school classes. Respondents to the experience survey showed marked improvement in their comfort working with patients with mental illness. Additionally, 40% "strongly agreed" or "agreed" that their experience influenced their interest in pursuing psychiatry as a career. CONCLUSION: This report describes a student-run psychiatry clinic with a dual mission of education and service, and the challenges associated with these sometimes competing goals. This clinic serves a vital need within our community and may be an example of the role that student-run clinics can have in fostering interdisciplinary care, psychiatric recruitment, and training for medical students.


Assuntos
Psiquiatria do Adolescente/organização & administração , Instituições de Assistência Ambulatorial/organização & administração , Psiquiatria Infantil/organização & administração , Transtornos Mentais/terapia , Faculdades de Medicina/organização & administração , Estudantes de Medicina , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
16.
Health Serv Res ; 52(2): 561-578, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28297075

RESUMO

OBJECTIVE: To learn if a quality of care Medicaid child psychiatric consultation service implemented in three different steps was linked to changes in statewide child antipsychotic utilization. DATA SOURCES/STUDY SETTING: Washington State child psychiatry consultation program primary data and Medicaid pharmacy division antipsychotic utilization secondary data from July 1, 2006, through December 31, 2013. STUDY DESIGN: Observational study in which consult program data were analyzed with a time series analysis of statewide antipsychotic utilization. DATA COLLECTION/EXTRACTION METHODS: All consultation program database information involving antipsychotics was compared to Medicaid pharmacy division database information involving antipsychotic utilization. PRINCIPAL FINDINGS: Washington State's total child Medicaid antipsychotic utilization fell from 0.51 to 0.25 percent. The monthly prevalence of use fell by a mean of 0.022 per thousand per month following the initiation of elective consults (p = .004), by 0.065 following the initiation of age/dose triggered mandatory reviews (p < .001), then by another 0.022 following the initiation of two or more concurrent antipsychotic mandatory reviews (p = .001). High-dose antipsychotic use fell by 57.8 percent in children 6- to 12-year old and fell by 52.1 percent in teens. CONCLUSIONS: Statewide antipsychotic prescribing for Medicaid clients fell significantly at different rates following each implementation step of a multilevel consultation and best-practice education service.


Assuntos
Antipsicóticos/uso terapêutico , Psiquiatria Infantil/organização & administração , Padrões de Prática Médica/estatística & dados numéricos , Encaminhamento e Consulta/organização & administração , Adolescente , Fatores Etários , Criança , Psiquiatria Infantil/estatística & dados numéricos , Pré-Escolar , Revisão de Uso de Medicamentos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Medicaid/estatística & dados numéricos , Estados Unidos , Washington
18.
Prax Kinderpsychol Kinderpsychiatr ; 66(1): 5-25, 2017 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-28042759

RESUMO

Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry In the past years the pressure in society and psychological problems in Germany have risen up. This can especially be verified by the great influx of utilization of child and adolescent psychiatric clinics through the admission of crisis. In this connection social disadvantaged female adolescents with a low socio-economic status, students of the secondary school, children in care and the ones whose parents have to manage their upbringing alone are preferentially affected. These developments require a fast adaptation of the supply system to the transformed demands, in particular in terms of outpatient treatment, as well as a closely and structured cooperation between the youth welfare and child and adolescent psychiatric clinics in their function as systems of help. In the script statistical data and adaptive approaches of a supply department of child and adolescent psychiatry are presented.


Assuntos
Psiquiatria do Adolescente/organização & administração , Serviços de Proteção Infantil/organização & administração , Psiquiatria Infantil/organização & administração , Intervenção na Crise/métodos , Intervenção na Crise/organização & administração , Necessidades e Demandas de Serviços de Saúde/organização & administração , Comunicação Interdisciplinar , Colaboração Intersetorial , Transtornos Mentais/terapia , Ambulatório Hospitalar/organização & administração , Unidade Hospitalar de Psiquiatria/organização & administração , Adolescente , Criança , Terapia Combinada , Registros Eletrônicos de Saúde/organização & administração , Alemanha , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Planejamento de Assistência ao Paciente/organização & administração , Estresse Psicológico/complicações
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