scholarly journals Psychiatry in Prague: some personal impressions

1991 ◽  
Vol 15 (1) ◽  
pp. 4-6 ◽  
Author(s):  
Alan Kerr ◽  
Edward Peck
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Child And Adolescent Psychiatry ◽  
Communist Regime ◽  
Counselling Services ◽  
Mental Health Funding ◽  
Medical Issues ◽  
Psychiatric Units ◽  
Adult Psychiatry

The sudden collapse of the communist order in Czechoslovakia and the formal installation of the new government in June 1990 has led, inter alia, to a fundamental reappraisal of mental health care. On a visit to Prague in September 1990 the system under the 40-year-old communist regime was still largely intact but clearly about to undergo major changes. Among the reform proposals made by a working group of the Ministry of Health and Social Affairs of the Czech republic are practices familiar to western psychiatrists: mental health care and specialist liaison in primary care settings; formal specialisation within psychiatry into general adult psychiatry, psychogeriatrics, child and adolescent psychiatry, psychotherapy; psychiatric units in general hospitals; community care with restructuring of funding away from the mental hospital budget and devolution to districts. More “humanisation” of psychiatry is envisaged, with choice of consultant, increased competition between doctors and legal definitions of involuntary treatment (Potucek et al, 1990). Voluntary organisations, existing until recently only underground, will be encouraged as also will be counselling services. Dementia, and drugs and alcohol misuse, are seen more as social service than medical issues. Of particular interest is a proposal to separate mental health funding from the rest of the health care budget.

Transference and Countertransference Dynamics in a Multifamily Group for Transgender Adolescents

2021 ◽  
Vol 108 (4) ◽  
pp. 457-474
Author(s):  
Nicolas Rabain
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Sexual Identity ◽  
Adolescent Psychiatry ◽  
Care Setting ◽  
Child And Adolescent Psychiatry ◽  
Consultation Service ◽  
Free Associate ◽  
Transference And Countertransference

This article is an account of a pioneering multifamily group for transgender adolescents. Meetings were conducted in a Sexual Identity Consultation Service in a Child and Adolescent Psychiatry Department in Paris. In addition to enabling both teenagers and their parents to escape a certain form of isolation, this novel mental health care setting also reinforced the ability of participants to free associate and to cathect substitute objects. The author highlights specific characteristics of transference movements and countertransference reactions of the therapists in this framework. An additional goal is to promote these innovative groups and to recommend similar groups for transgender adolescents and their parents.

A certificate in youth psychiatry: meeting the training needs of psychiatrists

2020 ◽  
pp. 103985622094301
Author(s):  
Iain Macmillan ◽  
Andrew Thompson ◽  
Megan Kalucy ◽  
Daniel Pellen ◽  
Eóin Killackey ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Youth Mental Health ◽  
Training Needs ◽  
Specialty Training ◽  
Optimal Care ◽  
Adult Psychiatry

Objective: This paper provides the rationale for the development of sub-specialty training in youth psychiatry. Method: Training needs for youth psychiatry are discussed and the opportunities provided by sub-specialisation in youth psychiatry are presented. Results: The majority of mental disorders have their onset prior to 25 years. There has been substantial recent growth in services to meet the clinical needs of young people. The development of these services has exposed gaps in current training for psychiatrists, which varies considerably between child and adolescent, and adult psychiatry. Competencies acquired by psychiatrists in youth mental health are non-standardised, which may hinder optimal care. Conclusions: Sub-specialty training in youth psychiatry is needed to meet workforce demands. The development of a certificate in youth psychiatry, by the RANZCP Section for Youth Mental Health, is underway. This will complement existing training and provide trainees and psychiatrists the opportunity to develop specialist skills in the provision of mental health care for young people negotiating the transition between adolescence and adulthood.

The use of family group conferences in mental health: Barriers for implementation

2016 ◽  
Vol 17 (1) ◽  
pp. 52-70 ◽  
Author(s):  
Gert Schout ◽  
Marjolein van Dijk ◽  
Ellen Meijer ◽  
Elleke Landeweer ◽  
Gideon de Jong
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Youth Care ◽  
Family Group ◽  
Added Value ◽  
Family Group Conference ◽  
Mental Health Barriers ◽  
Adult Psychiatry ◽  
Multiple Case

Summary The number of compulsory admissions in Dutch psychiatry has increased in the past 25 years. The reduction of coercion with Family Group Conferences in youth care has been successful. How, when and under what conditions can Family Group Conferences reduce coercion in adult psychiatry, is subject of an extensive inquiry. This paper, however, focusses on the reverse question, namely, in what circumstances can Family Group Conferences not be deployed? An answer to this question provides insights regarding situations in which Family Group Conferences may (not) be useful. Barriers in 17 cases were examined using multiple case studies. Findings The following barriers emerged: (1) the acute danger in coercion situations, the limited time available, the fear of liability and the culture of control and risk aversion in mental health care; (2) the severity of the mental state of clients leading to difficulties in decision-making and communication; (3) considering an Family Group Conference and involving familial networks as an added value in crisis situation is not part of the thinking and acting of professionals in mental health care; (4) clients and their network (who) are not open to an Family Group Conference. Applications Awareness of the barriers for Family Group Conferences can help to keep an open mind for its capacity to strengthen the partnership between clients, familial networks and professionals. The application of Family Group Conferences can help to effectuate professional and ethical values of social workers in their quest for the least coercive care.

scholarly journals Different Professional Ideal Types in the Inter-sectoral Management of Psychiatric Healthcare Trajectories

2020 ◽  
Vol 2 ◽  
pp. e3067 ◽  
Author(s):  
Jesper Frederiksen ◽  
Mette Bonde Dahl ◽  
Kim Jørgensen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Intersectoral Collaboration ◽  
Ideal Types ◽  
Governance Model ◽  
Neoliberal Governance ◽  
Psychiatric Units ◽  
Group Interviews ◽  
Regional Hospitals

Aim: To investigate how differences in types of professions and rationalities affect the management of inter-sectoral trajectories in psychiatric health care in the Capital Region of Denmark. Background: Some psychiatry users experience a lack of coherence between the mental health care treatment provided at hospitals and run by the regions, and that provided at residential psychiatric units run by municipalities. The literature points to various challenges in this field of research, related to transitions that need rethinking and further examination. Method: The approach is an eclectic use of theory and methods in a theory-governed analysis of empirical data built up from focus group interviews with professionals in mental health care centres and social psychiatric residencies. We classify the positions from the data using a theoretical framework based on Max Weber's theory of ideal types and from Pierre Bourdieu's concept of habitus. Our analysis outlines a theory about the practice of transitions in inter-sectoral trajectories in psychiatric health care.  Results: From the empirical material, we were able to construct different professional ideal types related to mental health care psychiatry and social psychiatry. The construction points to differences in the habitual basis of action that maintains institutional distinctions. Discussion: Differences in ideal types are connected to the prevailing positions of the two sectors, in which management in health care centres follows a dominant medical rationality, and management in residencies draws on a social and social educational legitimacy. Conclusion: We find differences between the rationalities and habitus of staff at regional hospitals and municipal residencies that enable us to explain how management contributes to trajectories in psychiatric health care. Choices concerning trajectory transitions relate to a combination of habitual professional inclinations and the management of trajectories streamlined through illness classification based on a neoliberal governance model. Future management must be aware of the different rationalities linked to professional and institutional logics when planning; and this requires reflexivity and awareness of the management of intersectoral collaboration.

scholarly journals Spain. The new mental health care system in Navarra, Spain

1990 ◽  
Vol 14 (8) ◽  
pp. 487-489
Author(s):  
Jone Aizarna ◽  
Jose A. Inchauspe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Publicly Funded ◽  
General Hospitals ◽  
Mental Health Care System ◽  
Health Area ◽  
Health Centres ◽  
Psychiatric Units ◽  
Day Hospitals

Your two correspondents are psychiatrists in their mid-30s working at two publicly-funded mental health centres in Navarra. We share the responsibility for co-ordinating the eight mental health centres, two day hospitals and two psychiatric units in general hospitals in the province. Each of us takes care of half these resources, grouped in a ‘mental health area’.

scholarly journals Primary Care Practitioner Training in Child and Adolescent Psychiatry (PTCAP): A Cluster-Randomized Trial

2019 ◽  
Vol 65 (5) ◽  
pp. 319-329
Author(s):  
Stacey D. Espinet ◽  
Sandra Gotovac ◽  
Sommer Knight ◽  
Larry Wissow ◽  
Merrick Zwarenstein ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Adolescent Psychiatry ◽  
Child And Adolescent Psychiatry ◽  
Practitioner Training ◽  
Attitudes And Knowledge ◽  
Cluster Randomized ◽  
Pediatric Mental Health

Objectives Rural primary care practitioners (PCPs) have a pivotal role to play in frontline pediatric mental health care, given limited options for referral and consultation. Yet they report a lack of adequate training and confidence to provide this care. The aim of this study was to test the effectiveness of the Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program, which was designed to enhance PCPs’ pediatric mental health care confidence. The program includes brief therapeutic skills and practice guidelines PCPs can use to address both subthreshold concerns and diagnosable conditions, themselves. Methods The study design was a pilot, cluster-randomized, multicenter trial. Practices were randomly assigned to intervention ( n practices = 7; n PCPs = 42) or to wait-list control ( n practices = 6; n PCPs = 34). The intervention involved 8 hr of training in practice guidelines and brief therapeutic skills for depression, anxiety, attention deficit hyperactivity disorder, and behavioral disorders with case discussion and video examples, while the control practiced as usual. A linear random-effects model controlling for clustering and baseline was carried out on the individual-level data to examine between-group differences in the primary (i.e., confidence) and secondary (i.e., attitude and knowledge) outcomes at 1-week follow-up. Results Findings were a statistically significant difference in the primary outcomes. Compared to the control group, the intervention group indicated significantly greater confidence in managing diagnosable conditions ( d = 1.81) and general concerns ( d = 1.73), as well as in making necessary referrals ( d = 1.27) and obtaining consults ( d = 0.74). While the intervention did not significantly impact secondary outcomes (attitudes and knowledge), regression analysis indicated that the intervention may have increased confidence, in part, by ameliorating the adverse impact of negative mental health care attitudes. Conclusion PTCAP enhances PCPs’ child/youth mental health care confidence in managing both general and diagnosable concerns. However, an 8-hr session focused on applying brief therapeutic skills was insufficient to significantly change attitudes and knowledge. Formal testing of PTCAP may be warranted, perhaps using more intensive training and including outcome assessments capable of determining whether increased PCP confidence translates to more effective management and better patient outcomes.

Child and Adolescent Mental Health Care

2014 ◽  
Author(s):  
Michael Kölch ◽  
Jörg M. Fegert ◽  
Ulrike M.E. Schulze
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Low Socioeconomic Status ◽  
Ethical Problem ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Care Assessment ◽  
Assessment And Treatment

In child and adolescent mental health care, the competing goals of protecting young people as a vulnerable population and their increasing legal autonomy constitute a specific ethical problem. Improving care, assessment, and treatment interventions requires research. Research that includes this vulnerable underage population has to be minimally burdensome and harmful and requires the informed consent of both children and parents. Therefore, adherence to evidence-based interventions and weighing the risks and benefits of interventions are of utmost importance in child and adolescent psychiatry. While access to mental health care can vary widely, it is crucial for at-risk populations such as children from families of low socioeconomic status, children of the mentally ill, and, in particular, children in youth welfare systems.

Child and adolescent psychiatry training and mental health care in Southeast Europe

2019 ◽  
Vol 29 (1) ◽  
pp. 29-39 ◽  
Author(s):  
H. Gregoric Kumperscak ◽  
C. Clausen ◽  
D. Anagnostopoulos ◽  
Z. Barac Otasevic ◽  
V. Boricevic Marsanic ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Adolescent Psychiatry ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Psychiatry Training ◽  
Southeast Europe

scholarly journals Smartphones in mental health: a critical review of background issues, current status and future concerns

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Michael Bauer ◽  
Tasha Glenn ◽  
John Geddes ◽  
Michael Gitlin ◽  
Paul Grof ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Critical Review ◽  
Clinical Utility ◽  
Current Status ◽  
Technology Usage ◽  
Smartphone Applications ◽  
Medical Issues

AbstractThere has been increasing interest in the use of smartphone applications (apps) and other consumer technology in mental health care for a number of years. However, the vision of data from apps seamlessly returned to, and integrated in, the electronic medical record (EMR) to assist both psychiatrists and patients has not been widely achieved, due in part to complex issues involved in the use of smartphone and other consumer technology in psychiatry. These issues include consumer technology usage, clinical utility, commercialization, and evolving consumer technology. Technological, legal and commercial issues, as well as medical issues, will determine the role of consumer technology in psychiatry. Recommendations for a more productive direction for the use of consumer technology in psychiatry are provided.

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