Abstract
Mental health disorders often develop during childhood and adolescence, causing long term and debilitating impacts at individual and societal levels. Local, early, and precise assessment and evidence-based treatment are key to achieve positive mental health outcomes and to avoid long-term care. Technological advancements, such as computerized Clinical Decision Support Systems (CDSSs), can support practitioners in providing evidence-based care. While previous studies have found CDSS implementation helps to improve aspects of medical care, evidence is limited on its use for child and adolescent mental health care. This paper presents challenges and opportunities for adapting CDSS design and implementation to child and adolescent mental health services (CAMHS). To highlight the complexity of incorporating CDSSs within local CAMHS, we have structured the paper around four components to consider before designing and implementing the CDSS: supporting collaboration among multiple stakeholders involved in care; optimally using health data; accounting for comorbidities; and addressing the temporality of patient care. The proposed perspective is presented within the context of the child and adolescent mental health services in Norway and an ongoing Norwegian innovative research project, the Individualized Digital DEcision Assist System (IDDEAS), for child and adolescent mental health disorders. Attention deficit hyperactivity disorder (ADHD) among children and adolescents serves as the case example. The integration of IDDEAS in Norway intends to yield significantly improved outcomes for children and adolescents with enduring mental health disorders, and ultimately serve as an educational opportunity for future international approaches to such CDSS design and implementation.
Highlights
One half of mental health problems develop prior to the age 15 [1] and 75% of all psychiatric disorders have their onset prior to the age of 25 [2,3,4]
To structure our discussion of the care context that a child and adolescent mental health services (CAMHS) Clinical Decision Support Systems (CDSSs) must support, we have identified four key design considerations, representing [1] the collaborative aspect of mental health care, [2] the many and distributed sources of information, [3] the complexity introduced by multiple stakeholders and comorbidities, and [4] the long-term perspective of the care process
Design of CDSS guidance based on analysis of health datasets has been found to provide greater improvement of clinical decision-making than guideline based CDSS suggestions alone [37]
Summary
One half of mental health problems develop prior to the age 15 [1] and 75% of all psychiatric disorders have their onset prior to the age of 25 [2,3,4]. In addition to Norway’s standardized, integral approach to patient assessment and treatment, the Norwegian Directorate of Health has established national clinical guidelines and care pathways (i.e., Pakkeforløp in Norwegian) for several mental health disorders, similar to the United States’ American Academy of Child and Adolescent Psychiatry (AACAP), formation of clinical updates and practice guidelines [25, 26]. To structure our discussion of the care context that a CAMHS CDSS must support, we have identified four key design considerations, representing [1] the collaborative aspect of mental health care, [2] the many and distributed sources of information, [3] the complexity introduced by multiple stakeholders and comorbidities, and [4] the long-term perspective of the care process
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
