P-308 - Restructuring child and adolescent mental health services in portugal

Abstract

Introduction According to WHO, 2 million young people in Europe suffer from mental disorders, sometimes receiving no care. In 2007, the Portuguese Government set a new Mental Health Plan (MHP), which included guidelines for Child and Adolescent Mental Health Services (CAMHS) development. Although positive aspects have been achieved, CAMHS evaluation identified significant deficiencies (accessibility, equity and quality of care). Objectives In what concerns children and adolescents, the MHP aims: To program new CAMHS in every central and district hospital, in order to cover the entire country. To ensure equity and promote human rights. To decentralise and integrate mental health in the general health system (including primary care) in order to increase access and reduce stigma; Methods A National Coordination Body for Mental Health has been empowered to assure the implementation of the MHP, with external monitoring from WHO. This Coordinating Body includes a team of child and adolescent mental health experts. Results There have been significant improvements in several key areas: diagnosis of current situation (structures, human resources), creation of new CAMHS, reshaping financing model proposals, planning of residential and day unit facilities for adolescents with double diagnosis, mental health promotion and domestic violence prevention programmes, advocacy and stigma. Conclusions The MHP can help to overcome some of the problems present in MHS in Portugal. Special attention should be given to CAMHS, namely through the increase of new services and new teams. Nevertheless, given the present crisis context, broad policies can negatively influence and restraint the mental health plan implementation.