Surmounting challenges in child and adolescent psychiatry
Imagine having to travel for four hours by car and/or by boat, sometimes even longer, before your child gets to have her much needed acute session with her psychologist.
In remote areas, there is an insufficient number of psychiatrists and psychologists. This leads to long waiting lists and often a rather heavy travel burden for both patients, their families and for travelling specialists.
Within the European project eCAP IT-based solutions are developed in order to improve psychiatric services to children and adolescents.
These solutions supports multi-professional collaboration between health professionals, the patient and the patient’s families. The aim is to provide high quality specialist services closer to the young person’s home.
Other expected effects are improved and more equal access to timely outpatient psychiatry services, specialist evaluation and treatment, reduced waiting times and more rational use of specialist services.
Newsletter no 1 - 2017
Latest news from Scotland
Beneficial early intervention?
When there is concern about a child or adolescent’s mental health, early intervention is important. Because of the inefficiency of the current systems in Scotland, families could suffer.
Children and young people in need of psychiatric help arrive at Child and Adolescent Mental Health Services (CAMHS) in Scotland. Within the frames of the European project eCAP, new, potentially systems that are more efficient are tested.
- We believe that the Development and Wellbeing Assessment (DAWBA) may improve mental health in children and young people through reduced waiting times to services, and better quality of referrals, explains Professor Phil Wilson at the Centre for Rural Health.
The DAWBA is a computerised structured instrument for gathering diagnostic data from parents or guardians, teachers and young people themselves. Referrals can come from GPs, paediatricians, health visitors, school nurses, primary mental health workers and educational psychologists.
Randomised controlled trial
- We will ask 246 families in the north NHS Highland region to participate in a randomised controlled trial where they will either receive the DAWBA at referral, or go through the current standard assessment process (which may vary depending on the referrer and the service), explains Professor Wilson.
- All families where there are mental health concerns about children and young people aged 2-18 years of age will be offered participation. We will collect detailed information regarding what happens to families in both groups. We will begin recruiting to eCAP: DAWBA in April 2017, and will see the first results by December 2018.
The Centre for Rural Health presented a poster on the eCAP DAWBA RCT. The event was the NHS Highland Research, Development and Innovation Annual Conference on 25th November 2016.
Professor Phil Wilson, Dr Lucy Thompson and Gerry King are shown on the attached photograph, together with the poster.
Latest news from Finland
Improve quality of services
During spring 2017, the eCap project will launch an electronic booking and video conferencing system for child psychiatric services in Northern Savo, Finland.
- This system will allow consultations, supervision and support for treatment, says Kirsi Bykachev, Project manager. She explains that electronic forms gathering background information from the parents, teacher and the child him/herself will complement the VideoVisit services.
- The video consultation will contribute to the transfer of knowledge and treatment capability from the Department of Child Psychiatry in Kuopio University Hospital (KUH) to primary health care, as well as improve multi-professional collaboration, says Bykachev.
In addition, a combined independent and virtual training course within child psychiatry enhances the basic level of knowledge with the professionals. The course is produced in collaboration with the Department of Nursing Science at the University of Eastern Finland (UEF).
First consultations available
The project team has visited local municipalities to provide information about general child psychiatry services in the region. The team has also installed the software and hardware needed to develop the services.
- In the booking system, the first consultations are already available for primary health care personnel, while personnel in the Department of child psychiatry is being trained to use the system, says an enthusiastic Project manager.
Also, surveys have been distributed to professionals working in daycare, early and basic education as well as in social and health care in the region. The results are being analyzed and will guide the further development work in the project.
Latest news from Norway
Enormous travel distances
When a child or a young person is in need, the nearest psychiatric help can be very far away in Northern Norway.
The Child and Adolescent Psychiatry Clinic (CAP) at the University Hospital of North Norway provides diagnostics and treatment to children and youngsters in the entire region. This is where the eCAP project has its’ test site.
- The clinic serves large geographic areas. Travelling to meet specialists at the hospital takes several hours, sometimes even up to eleven hours. Critical hours where the person in need can get much worse, says Eirin Rødseth, Project manager for eCAP Norway.
The University Hospital of North Norway engages in developing services that will meet the challenges patients are facing in this large geographical area.
- The clinic will create videoconference-based services to children and adolescents who has to travel long distances to get treatment at the hospital or if absence from school is not wanted. Treatment will also be available to patients who are unable to travel due to their mental health problems. In some situations, consultations will be done only by video-conferencing, while mostly it will be a combination with face-to-face. All services are developed in close cooperation with the children’s families, primary health care, public health nurses, schools, child welfare authorities and other hospital clinics, explains Eirin Rødseth. She further explains that services are also tailored to meet the needs for counselling of the patient's family as well as local therapists and other professionals.
Home-based service possible
- Patients and their families will use videoconference studios in their own communities; public health centres, GP offices, and we are looking into the possibility for the patients to use their own home-equipment, says Eirin Rødseth who underlines that several risk factors need to be assessed and addressed before launching this service.
Latest news from Sweden
The eCAP project in Sweden will perform a baseline survey among professionals in primary health care and professionals working within child and adolescent psychiatry.