Kinder- und Jugendpsychiatrie/Psychotherapie versus Kinder- und Jugendhilfe

[Child and adolescent psychiatric and therapeutic treatment needs in care settings in the Lower Austrian industrial district. A survey of the demand situation]

An increasing need for child and adolescent psychiatric care is clearly observed in recent years. The present study deals with 20 child and youth care facilities taking care of 439 children and adolescents, in the industrial district, in Lower Austria. The aim of the study is to evaluate treatment needs of this special group of patients. The care facilities reported that 270 children and adolescents (62%) show psychiatric problems. Of these, 220 (50.1%) are diagnosed with one or more psychiatric diagnoses, and 200 children and adolescents are receiving child and adolescent psychiatric treatment. Eleven care facilities reported the necessity for treatment in 80-100% of their accommodated children and adolescents. This results in highly stressful working conditions for professional psychosocial helpers and high treatment needs within their fosterlings. It is evident that more intensive networking and cooperation between institutions and helpers involved is necessary. Further, the development of new, low-threshold child and adolescent psychiatric services would be desirable to adequately meet the increasing need for psychiatric treatment in children and adolescents.

[Discharge management in pediatric and adolescent psychiatry : Expectations and realities from the parental perspective]

BACKGROUND

Interface management after inpatient care for mentally ill children and adolescents has been proven to be a breaking point in good transition of care between child and adolescent psychiatry, social welfare services, schools, job centre and the judicial system. Criteria for successful discharge management do not exist in child and adolescent psychiatry. Aim of the study ASpeKT was to survey parents on their perception of interface management and to derive recommendations for discharge management.

METHODS

Data regarding interface management were retrieved from parents (T3, n = 124, T4, n = 81) 6 months (T3) and 12 months (T4) after discharge.

RESULTS

The parents stated that accessible help after discharge from inpatient treatment is essential for stability and requires a good coordination. Parents named that they perceived helpful for successful interface management: a case manager, early round table meetings, support in returning to school, seamless access to outpatient follow-up appointments as well as information on further treatment options and contact data.

CONCLUSION

From the perspective of affected families a proactive early individual and reliable care coordination by a constant contact person is essential for a good discharge management.

Hilfebedarf und Hilfesysteme für Kinder und Familien

Zusammenfassung. Für Kinder und Jugendliche mit psychischen und Verhaltensstörungen sowie Entwicklungsstörungen existiert in Deutschland ein differenziertes Angebot an Hilfen. Dieses reicht von der Pädiatrie, über die Kinder-/Jugendpsychiatrie, die ambulante Psychotherapie bis zur Kinder- und Jugendhilfe und zu schulischen Fördermaßnahmen. Die Effizienz dieser Hilfesysteme hängt auch von deren Vernetzung und interdisziplinären Kooperation ab. Die Lösung von Schnittstellenproblemen steigert Therapieerfolge und verbessert die Langzeiteffekte.

Schnittstellenkoordination von systemübergreifenden Hilfen für Kinder und Jugendliche mit psychischen Beeinträchtigungen

Zusammenfassung. Schnittstellen zwischen psychosozialen Hilfesystemen stellen Sollbruchstellen einer gelingenden systemübergreifenden Behandlung psychisch erkrankter Kinder/Jugendlicher dar. Daten zu Schnittstellenmanagement in Deutschland liegen bisher nicht vor. Ziel der Studie ASpeKT war es, zu vier Zeitpunkten (T1 Aufnahme, T2 Entlassung, T3 6 Mo und T4 12 Mo nach Entlassung) den Ist-Stand von installierten Hilfen bei psychisch erkrankten Kindern und Jugendlichen ( n=191) zu erheben, Patientenzufriedenheit zu evaluieren sowie dies an zwei, strukturell unterschiedlichen Standorten (Klinik A/Klinik B) zu vergleichen. Zu T2 erhielten 13 % der Patienten keine Hilfen. 43,6 % (A) bzw. 70,4 % (B) erhielten Psychotherapie (PT), 67,3 % (A) bzw. 80,3 % (B) Jugendhilfemaßnahmen (JH), 37,6 % (A) bzw. 16.9 % (B) schulische Unterstützung. Gute Schnittstellenkoordination ist prognostisch essentiell, um den meist noch komplexen Hilfebedarf psychisch erkrankter Kinder/Jugendlicher nach stationärer Behandlung abzubilden.

Come together: case specific cross-institutional cooperation of youth welfare services and child and adolescent psychiatry

BACKGROUND

Due to the increasing rate of children and families who require support from both youth welfare services and from mental health services, a solid cross-institutional cooperation is needed to provide coordinated and integrated help. Studies involving not only qualitative, but also quantitative information from both services regarding not only general, but also case specific views on cross-institutional cooperation and psychosocial needs are lacking.

METHODS

Hence, we collected data from n = 96 children and families who received support from youth welfare office (YWO) and child and adolescents psychiatry (CAP) simultaneously. In a longitudinal survey, we assessed the evaluation of case specific cross-institutional cooperation and psychosocial needs by employees of YWO and CAP as well as descriptive data (including psychopathology of children) over a 6-month period. Repeated-measures ANOVAs were conducted to assess the effects of time and institution (YWO/CAP) on employees' evaluation of case specific cross-institutional cooperation and psychosocial needs as well as children's psychopathology.

RESULTS

The data showed that generally YWO employees rated the case specific communication better than CAP employees. Furthermore, CAP employees estimated psychosocial needs higher than YWO employees did. The employees' evaluation of total case specific cross-institutional cooperation did not differ between the employees of both institutions; it further did not change over time. The case specific evaluations did not correlate between the case responsible employees of YWO and CAP.

CONCLUSION

The data showed satisfaction with the case specific cross-institutional cooperation in general, but meaningful differences in case specific ratings between both institutions indicate the possibility and need for improvement in daily work and cooperation as well as in regulations and contractual agreements. The implementation of more exchange of higher quality and transparency will ensure smoother cross-institutional cooperation. Future research should pursue this topic to convey the need for further improvement in cross-institutional cooperation into decision-making processes and to evaluate the success of innovative projects in this field.

Kindheit und Entwicklung – 25 Jahre

Zusammenfassung. Im Jahre 1992 wurde die Zeitschrift „Kindheit und Entwicklung“ gegründet und hat sich inzwischen zum führenden Publikationsorgan der Klinischen Kinderpsychologie in den deutschsprachigen Ländern etabliert. Themen der Pädiatrischen Psychologie, Kinderpsychiatrie, Kinder- und Jugendhilfe wurden genauso publiziert wie Beiträge zur Kinderpsychotherapie, Angewandten Entwicklungsdiagnostik und Entwicklungspsychopathologie. Knapp 100 Themenschwerpunkte wurden in diesem Zeitraum bearbeitet.