{"id":3094,"date":"2008-09-14T08:26:03","date_gmt":"2008-09-14T08:26:03","guid":{"rendered":"http:\/\/snpcar.ro\/?p=3094"},"modified":"2018-09-14T08:26:12","modified_gmt":"2018-09-14T08:26:12","slug":"english-mental-wellbeing-of-children-in-europe-plans-and-perspectives","status":"publish","type":"post","link":"https:\/\/snpcar.ro\/en\/english-mental-wellbeing-of-children-in-europe-plans-and-perspectives\/","title":{"rendered":"MENTAL WELLBEING OF CHILDREN IN EUROPE PLANS AND PERSPECTIVES"},"content":{"rendered":"<p><\/p>\n<p class=\"Style17\"><strong>Epidemiology<\/strong><\/p>\n<ul>\n<li>no recent epidemiological studies<\/li>\n<li>prevalence of psychiatric conditions (adult &amp; child population) in 6 months around 20%<\/li>\n<\/ul>\n<p class=\"Style30\">Indicators suggesting significant higher values for the last decade in incidence of mental health disorders:<\/p>\n<ul>\n<li>general deterioration of the people&#8217;s health condition<\/li>\n<li>increased number of abuses, addictions to psychoactive subst<\/li>\n<li>a higher suicide rate,<\/li>\n<li>overwhelming social stress factors (eco\u00adnomic decline, high unemployment rate, low quality of life)<\/li>\n<li>expansion of agressive and violent be\u00adhaviors, all reflecting an alarming mental health status<sup>1)<\/sup>.<\/li>\n<\/ul>\n<p class=\"Style17\"><strong>Peculiarities<\/strong><\/p>\n<ul>\n<li>Former decades of pretending the Jack of social problems&#8221; and mandatory child-bearing in the political regime resulted in an unfortunate partial overlapping of \u201eChild Neuropsychiatry&#8221; with poor, low-quality social services.<\/li>\n<li>Low quality medical care of pregnancy and delivery, child abandonment and chronic deprivation in orphanages resulted in a high incidence of consecutive neuro-psychiatric disorders.<\/li>\n<li>Even now, after 18 years of change, we still confront long-time sequelae of this\u00a0phenomenon.<\/li>\n<li>Nowdays, children live and learn in a world undergoing significant social and economic changes<\/li>\n<li>The experiences in early childhood, powerful influencing the child&#8217;s development, take place frequently in a restricted, precarious and agressive social environment<\/li>\n<li>Parents divorce, work all day long or go abroad to work, becuase of severe finnancial problems<\/li>\n<\/ul>\n<p class=\"Style2\">1) &#8211; Mental Health Policy of the Romanian Ministry of Health, 2006,\u00a0www.ms.ro<\/p>\n<p class=\"Style2\"><strong>A. Health Promotion Services<\/strong><\/p>\n<p class=\"Style26\">Clinics for Child and Adolescent Psychiatry and Neurology Timi\u015foara (Child Emergency Hospital \u201eLouis Turcanu&#8221;)<\/p>\n<p class=\"Style26\">inpatient service:\u00a050 beds\u00a0<strong>Multidisciplinary team<\/strong>\u00a05 specialist doctors, 2 clinical psychologists, 1 social worker, 1 speech therapist, 1 kinetother\u00a0<strong>Counseling and psychotherapy\u00a0<\/strong>(family therapy,\u00a0 logotherapy,\u00a0 existential analysis, cognitive-behavioral therapy)\u00a0<strong>Psycho-sensorio-motor stimulation Speech therapy Mototherapy<\/strong><\/p>\n<p class=\"Style26\"><strong>Special school\u00a0<\/strong>(specialised teachers in assessment and treatment of school failure, academic disorders)\u00a0<strong>outpatient service:<\/strong><\/p>\n<p class=\"Style26\">Centre of Child Mental Health: 50 places\u00a0<strong>Multidisciplinary team<\/strong>\u00a01 specialist doctors, 1 clinical psychologist, 1 social worker, 1 kinetother<\/p>\n<p class=\"Style26\"><strong>Counseling and psychotherapy<\/strong>\u00a0(family therapy, logotherapy, existential analysis, CBT)<\/p>\n<p class=\"Style2\"><strong>Psycho-sensorio-motor stimulation<\/strong><\/p>\n<p class=\"Style2\"><strong>Speech therapy Mototherapy<\/strong><\/p>\n<p class=\"Style18\"><strong>Special school\u00a0<\/strong>(specialised teachers in assessment and treatment of school failure, academic disorders)<\/p>\n<p class=\"Style2\"><strong>externalised community based Centre for Autistic Children:<\/strong><\/p>\n<p class=\"Style18\">15 places in day-time care<\/p>\n<p class=\"Style18\">15 places for home-based interventions.<\/p>\n<p class=\"Style18\"><strong>2 Multidisciplinary teams\u00a0<\/strong>1 specialist doctor, 2 clinical psychologist, 1 social worker, 1 speech therapist, 1 kinetotherapist, 6 special educators<\/p>\n<p class=\"Style18\"><strong>specific therapies<\/strong>\u00a0(CBT, ABA, TEACCH, sensory integration)<\/p>\n<p class=\"Style2\"><strong>family counseling and video-intervention training parents<\/strong><\/p>\n<p class=\"Style2\"><strong>Psycho-sensorio-motor stimulation<\/strong><\/p>\n<p class=\"Style2\"><strong>Speech therapy<\/strong><\/p>\n<p class=\"Style2\"><strong>Mototherapy<\/strong><\/p>\n<p class=\"Style2\"><strong>Special school based on TEACCH approach<\/strong><\/p>\n<p class=\"Style1\"><strong>B. Screening services:<\/strong><\/p>\n<p class=\"Style2\"><strong>network of family doctors, screening for pervasive developmental disorders with standardised instruments<\/strong><\/p>\n<p class=\"Style1\"><strong>C.\u00a0 Prevention services<\/strong><\/p>\n<p class=\"Style2\"><strong>Secondery and tertiary prevention, provided by mental health professionals active in variousclinicalandcommunity-basedcentres, govemamental and non-governamental.<\/strong><\/p>\n<p class=\"Style105\"><strong>D.\u00a0 Education services mental health professionals: trainees in Child and Adolescent Psychiatry, Psychotherapy, Psychology, Social Work, Special Education.<\/strong><\/p>\n<p class=\"Style2\"><strong>University Department Child and Adolescent Psychiatry<\/strong><\/p>\n<p class=\"Style18\"><strong>Family and Child Centre Audio-Video Research and Education Lab in Family Therapy and Child and Adolescent Psychiatry.<\/strong>\u00a0Therapeutic sessions can be watched, supervised and discussed (one-way mirror, computerised audio &#8211; video recording system). Resource base in Child and Adolescent<\/p>\n<p class=\"Style18\">Psychiatry, Family Psychopathology and Theraputic Techniques.<\/p>\n<p class=\"Style2\"><strong>Department of School Psychology and Cognitive Develoment with psychologic diagnostic tools, for a complete psycho-educational assessment of children with learning disorders, school failure, ADHD, conduct disorders.<\/strong><\/p>\n<p class=\"Style26\">The Lecture Room with audio-videosystem Statistics department for creating and using the databases<\/p>\n<p class=\"Style54\"><strong>E. Early intervention services<\/strong><\/p>\n<ul>\n<li>Clinics for Obstetrics &#8211; screening and intervening in cases of risk deliveries and complicated deliveries (neurologic injuries)<\/li>\n<li>Clinics for Child and Adolescent Psychiatry and Neurology<\/li>\n<li>Screening and early intervention (&lt; 3 years of age) in deviant development (pervasive type) &#8211; Community-based Centre for Autistic Children<\/li>\n<li>Early intervention in cases of attachment disturbances, child abandonment and child maltreatment &#8211; NGOs as House with Open Windows, promoting a professional suppleant family<\/li>\n<li>Early intervention in case of sensorial impairment (network with otho-rhino-laringology clinics, to promote cochlear implant and consecutive rehabilitation speech therapy)<\/li>\n<\/ul>\n<p class=\"Style54\"><strong>F.\u00a0 Services for children and young people who have long-term needs<\/strong><\/p>\n<p class=\"Style18\">Special schools:<\/p>\n<ul>\n<li>For mental retardation<\/li>\n<li>For visual impairment<\/li>\n<li>For auditory impairment (kindergarden, school)<\/li>\n<li>For autistic children<\/li>\n<li>For behavior disturbed &#8211; delinquent adolescents<\/li>\n<\/ul>\n<p class=\"Style18\">day &#8211; time care with rehabilitation programme<\/p>\n<ul>\n<li>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Community-based\u00a0 Centre for Autistic Children, NGO&#8217;s as &#8220;Speran\u0163a&#8221; (&#8220;Hope&#8221;) for children, &#8220;Pentru Voi&#8221; (&#8220;For You&#8221;) for young people.<\/li>\n<li>&#8211; Home-based intervention service for autistic children<\/li>\n<\/ul>\n<p class=\"Style2\"><strong>G. Plans for young people&#8217;s transition to other services<\/strong><\/p>\n<ul>\n<li>After 18 years of age, patients in Child and Adolescent Psychiatry are transferred (if necessary) with a special letter containing all important issues in their clinical evolution, to adult services.<\/li>\n<\/ul>\n<p class=\"Style17\"><strong>Training<\/strong><\/p>\n<ul>\n<li>Qualified specialists : 270<\/li>\n<li>Senior trainees: 70<\/li>\n<li>Academic departments &#8211; 3 (Timi\u015foara, Cluj, Bucharest)<\/li>\n<li>Type of training (5 years: teaching, clinical stages, research).<\/li>\n<\/ul>\n<p class=\"Style30\">Candidates have to spend four years in child and adolescent psychiatry and one year for complementary studies (paediatrics, child and adult neurology, adult psychiatry, endocrinology, neurosurgery, functional explorations, community-based services)<\/p>\n<p class=\"Style30\">To practice the speciality is necessary a final examination (a written and a practical phase, with a case presentation).<\/p>\n<p class=\"Style17\"><strong>Recent developments in Romanian Mental Health Policies and Legislation<\/strong><\/p>\n<p class=\"Style30\">Principles of Mental Health Policy in Romania:<\/p>\n<ol>\n<li>The responsibility of the community-based team<\/li>\n<li>Participation of the community<\/li>\n<li>Accessibility of services<\/li>\n<li>Balance among the system components<\/li>\n<li>Continuity of care<\/li>\n<li>Minimal restrictive alternatives<\/li>\n<li>Accent on rehabilitation<\/li>\n<li>Specialization of care<\/li>\n<li>Involvement of beneficiaries and their families in care process<\/li>\n<li>Evidence-based clinical and communitary practice<\/li>\n<\/ol>\n<p class=\"Style17\"><strong>Priorities<\/strong><\/p>\n<ul>\n<li>Antistigma program<\/li>\n<li>Community mental health centres<\/li>\n<li>Quality improvement of hospital services<\/li>\n<li>Training and education Users involvment<\/li>\n<li>Implementation of the Law on Mental Health and Protection of People With Mental Disorders<\/li>\n<li>Establishment of National Center for Mental Health within the Institute for Health Research and Development<\/li>\n<li>110 monitors of patients rights in mental hospitals<\/li>\n<li>Funds allocated for improving living conditions in 7 hospitals<\/li>\n<li>Establishment of 10 community mental health centers<\/li>\n<\/ul>\n<p class=\"Style30\">The Revised Action Plan for implementing the Mental Health Reform Strategy in Romania<\/p>\n<p class=\"Style40\"><strong>Main strengths of the CAMH system:<\/strong><\/p>\n<ul>\n<li>ongoing implementing of the new Mental Health Strategy<\/li>\n<\/ul>\n<p class=\"Style40\"><strong>Main weaknesses of the CAMH system<\/strong><\/p>\n<ul>\n<li>no governamental department for child and adolescent psychiatry<\/li>\n<li>Still, adult psychiatry is far more preva\u00adlent and finnanced (compared with child psychiatry) in National Programmes<\/li>\n<li>Postgraduate training in psychotherapy is not compulsory<\/li>\n<li>The specialists number is insufficient[1]<\/li>\n<li>The specialists distribution is inequal all<\/li>\n<\/ul>\n<p class=\"Style18\">over the country Romania has 22,810,035 inhabitants (4,800,000 &lt;18 years , 21%). From 11 Medical Faculties, only 3 have the Child and Adolescent Psychiatry discipline: Bucharest, Cluj and Timi\u015foara (also Centers for postgraduate training). To 1 specialist child psychiatrist, correspond around 24,000 children. Lack of associated proffesionals and connected services reduces the quality and the complexity of the medical efficiency.<\/p>\n<p class=\"Style17\"><strong>Future Perspectives<\/strong><\/p>\n<ul>\n<li>Training of qualified personnel in multi-professional teams<\/li>\n<li>Orienting toward community-based care<\/li>\n<li>Sectorising through schools monitohsed by team: school psychologist, school doctor, social worker; relevant cases transferred to specialists in Centers of Mental Health<\/li>\n<li>National Programmes for Autism and ADHD<\/li>\n<li>New approach of care in multiprofes-sional teams, aiming to change old men\u00adtalities.<\/li>\n<li>Establishing and organising Centres of Child and Adolescent Mental Health<\/li>\n<\/ul>\n<div class=\"columns-download\">\n<p><a class=\"button\" href=\"http:\/\/snpcar.ro\/wp-content\/uploads\/2018\/09\/18.pdf\"><i class=\"fa fa-download\"><\/i> DOWNLOAD ARTICLE<\/a><\/p>\n<\/div>\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>Epidemiology no recent epidemiological studies prevalence of psychiatric conditions (adult &amp; child population) in 6 months around 20% Indicators suggesting significant higher values for the last decade in incidence of mental health disorders: general deterioration of the people&#8217;s health condition increased number of abuses, addictions to psychoactive subst a higher suicide rate, overwhelming social stress [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"footnotes":""},"categories":[377,376],"tags":[382,350],"class_list":["post-3094","post","type-post","status-publish","format-standard","hentry","category-numar-1-vol-2008","category-vol-2008","tag-otilia-secara","tag-tiberiu-mircea"],"_links":{"self":[{"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/posts\/3094","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/comments?post=3094"}],"version-history":[{"count":2,"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/posts\/3094\/revisions"}],"predecessor-version":[{"id":3097,"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/posts\/3094\/revisions\/3097"}],"wp:attachment":[{"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/media?parent=3094"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/categories?post=3094"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/snpcar.ro\/en\/wp-json\/wp\/v2\/tags?post=3094"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}