Background and Expectations for Reorganizing Mental Health Services for Children and Adolescents

Abstract

Background: сhild psychiatry is essential for preventing adult mental diseases, due to the timely detection of a disease and the initiation of treatment. Thus, the choice of the optimal model of care and the corresponding transformation of the service are important. This work should be preceded by the study of current perceptions of the service and the prospects for its development among specialists and representatives of patients.The purpose: to study representatives’ expectations and fears related to the service, as well as to investigate the current needs of the professionals and their readiness for the service reform in Moscow.Material and methods: 657 district child psychiatrists and employees of clinical departments of children mental hospital in Moscow, and 361 consumers of the service filled in paper questionnaires on October 7–10, 2019.Results: neither the specialists nor the consumers have a general idea for the service development in Moscow. The professionals are more likely to consider their own field of work as a priority for development. The patient representatives expressed a wish for expanding service availability (including its territorial basis), while only 8% advocate the development of outpatient care as a priority. 49% of the specialists see a child as a main recipient of care, and 29% consider a family as a main recipient. 76% of the specialists found it difficult to answer the question about the existence of rules for interaction with a family. The experts consider the main request of a child as “condition stabilization” (85%), while the children themselves do not think in such categories. The myths about the service among the health workers and general population are similar, with the population expressing fears about being “registered” if they seek psychiatric help. At the same time, the loyalty of mental health specialists is comparable to the average in Moscow, primarily due to the high assessment of the staff.Conclusion: the study revealed a number of the related issues which are important to consider when reforming the service.