Child Mental Health Specialists Research Articles

KINDERGARTEN PRINCIPALS' VIEWS ON INCLUSIVE EDUCATION: A FOCUS GROUP STUDY

In Turkey, as in many other countries, laws, and regulations protect every child's right to an education. This encompasses all disabilities that need special education. Distinct features and disability groups cannot benefit from education without specific adjustments in general education for students who vary considerably from their classmates and have different disability groups. Starting special education at an early age is one of the most fundamental concepts of special education and is incredibly important, just as it is crucial to start education at an early age in kindergarten education. This research aims to ascertain the perspectives and recommendations of school administrators who have inclusive pupils in their kindergartens on inclusive education. The study included a qualitative research approach known as focus group discussions. At the end of the study, it is discovered that the majority of the information resources of kindergarten principals working in kindergartens are gathered in the form of university education, in-service training, school guidance service, and individual efforts, and that mainstreaming students only have a hazy understanding of their rights as outlined in the constitution, laws, regulations, and directives. When working with special education children, the topics they need assistance with are communication, family education, behaviour shaping, and the preparation of individual education plans, and the resources they use to guide families are books, special education specialists, child mental health specialists, relevant departments of universities, guidance research centres, and so on. It is expanding as a school guidance service. Participating kindergarten principals generally indicated that inclusive education was very helpful to their pupils, while a few participants claimed that the lack of adequate physical conditions and opportunities hindered this advantage. Keywords: Preschool education, kindergarten, special education, inclusive education.

ADHD and obesity: A narrative review from the perspective of a child psychiatrist

PurposeThis narrative review is aimed at presenting recent evidence on the association between two widespread, chronic, and growing diseases in childhood: attention-deficit/hyperactivity disorder (ADHD) and obesity. Several hypotheses have been put forward about the correlations between the two conditions, concerning prenatal, perinatal and postnatal factors. MethodWe approached this topic through a search of recent literature on this subject, from the perspective of a child psychiatrist, a specialist in child development with an integrative view of the various factors involved in the onset, development and maintenance of a pathological condition, as well as a clinical approach, directed at addressing these factors in a combined manner. ConclusionThe most important point that emerged from our research and to be considered, as a child mental health specialist, seems to maintain an integrated view of the etiology and the management of mental disorders, through an integrative approach.

Reflections on "Building Back Better" Child and Adolescent Mental Health Care in a Low-Resource Postemergency Setting: The Case of Sierra Leone.

Over the past three decades, Sierra Leone has experienced two major humanitarian crises: an armed conflict (1991–2002) and an Ebola virus disease outbreak (2014–2015). In addition to these country-wide crises, the capital Freetown experienced a mudslide affecting thousands of people in 2017. In response to these emergencies, donors and aid organizations showed an increased interest in supporting and implementing mental health and psychosocial support interventions. Despite these efforts, the mental health infrastructure of the country remains frail. Specifically, systemic improvements in the implementation of evidence-based mental health care for children and adolescents appear to be lacking. In this article, the Interactive Systems Framework for Dissemination and Implementation is used as a tool to analyze issues related to the development of a sustainable, contextually relevant child and adolescent mental health-care delivery system. The author draws on her long-term experience as a child mental health specialist in Sierra Leone. Observations and hypotheses are tested and supplemented by formal and informal reports and national and international literature. The three systems described by the Interactive Systems Framework are explored in the context of Sierra Leone: (1) Synthesis and Translation, (2) Support, and (3) Delivery. Interaction between the three Systems is discussed as critical to the successful dissemination and implementation of interventions. Ample attention is given to contextual factors that are believed to be paramount to the development of child and adolescent mental health care in Sierra Leone. The article concludes with a reflection on the usefulness of the Interactive Systems Framework in the dissemination and implementation of child and adolescent mental health-care interventions in low-resource, postemergency settings. It is suggested that, in addition to funding and policies, the child and adolescent mental health system in Sierra Leone could benefit from the development of contextually relevant interventions, improvement of capacity-building efforts, and acknowledgment of the role of community-based practitioners in the delivery of services. Local mental health experts, especially those trained in child and adolescent mental health, should be empowered to work together with culturally competent expatriate professionals to improve child and adolescent mental health care in Sierra Leone.

Improving Access to Mental Health Care for Children: The Massachusetts Child Psychiatry Access Project

Inadequate access to care for mentally ill children and their families is a persistent problem in the United States. Although promotion of pediatric primary care clinicians (PCCs) in detection, management, and coordination of child mental health care is a strategy for improving access, limitations in training, time, and specialist availability represent substantial barriers. The Massachusetts Child Psychiatry Access Project (MCPAP), publicly funded with 6 regional consultation teams, provides Massachusetts PCCs with rapid access to child psychiatry expertise, education, and referral assistance. Data collected from MCPAP teams measured participation and utilization over 3.5 years from July 1, 2005, to December 31, 2008. Data were analyzed for 35,335 encounters. PCC surveys assessed satisfaction and impact on access to care. The MCPAP enrolled 1341 PCCs in 353 practices covering 95% of the youth in Massachusetts. The MCPAP served 10,114 children. Practices varied in their utilization of the MCPAP, with a mean of 12 encounters per practice per quarter (range: 0-245). PCCs contacted the MCPAP for diagnostic questions (34%), identifying community resources (27%), and consultation regarding medication (27%). Provider surveys revealed improvement in ratings of access to child psychiatry. The rate of PCCs who reported that they are usually able to meet the needs of psychiatric patients increased from 8% to 63%. Consultations were reported to be helpful by 91% of PCCs. PCCs have used and value a statewide system that provides access to teams of psychiatric consultants. Access to child mental health care may be substantially improved through public health interventions that promote collaboration between PCCs and child mental health specialists.

Attention deficit hyperactivity disorder (ADHD): review for primary care clinicians.

Attention deficit hyperactivity disorder (ADHD) is characterised by impulsivity, hyperactivity and inattention. Up to 5% of primary school age children have ADHD. Both genes and environment play a role in the aetiology of ADHD. If left untreated, children with ADHD demonstrate a range of poor long-term psychosocial outcomes. The Strengths and Difficulties Questionnaire (SDQ) may be used to screen children for a range of psychiatric disorders, including ADHD.(1) Principal management options include medication (methylphenidate and atomoxetine are the first line), parent training programmes and school based interventions. It is important to provide a dedicated child mental health specialist service for children with ADHD. In addition to following the National Institute for Health and Clinical Excellence (NICE) guidelines,(2) the authors recommend the use of wider systemic approaches and early intervention to optimise the effectiveness of recommended treatment options.

Practitioners' attitudes toward the use of treatment progress and outcomes data in child mental health services.

This study focused on practitioners' attitudes toward child mental health services data collection and outcomes measurement in university-based and community-based clinics. It is relevant to the burgeoning field of empirically based mental health therapy management because it examines one potential barrier to psychotherapy and pharmacotherapy strategies (i.e., practitioners' attitudes toward outcomes measurement) that are informed by real-time, clinically relevant data. Two site differences were noted regarding the utility of specific questionnaires and the perceived burden of conducting outcomes measurement. At both sites, practitioners held positive attitudes about outcomes measurement. Compared with psychologists and other child mental health specialists, psychiatrists had less favorable attitudes toward outcomes evaluation. Practitioners who rated outcomes evaluation as more important also perceived less burden associated with such evaluation efforts. Increased understanding of the utility of systematic clinical data collection is more likely to occur in an organizational culture in which treatment progress and outcomes measurement is integral to clinical work.

Depression and Bipolar Support Alliance Consensus Statement on the Unmet Needs in Diagnosis and Treatment of Mood Disorders in Children and Adolescents

To focus attention on the critical unmet needs of children and adolescents with mood disorders and to make recommendations for future research and allocation of healthcare resources. The 36-member Consensus Development Panel consisted of experts in child/adolescent or adult psychiatry and psychology, pediatrics, and mental health advocacy. Reviews of the literature concerning youth mood disorders were performed on the subjects of risk factors, prevention, diagnosis, treatment, and services delivery, and opinions and experiences of mental health advocates were obtained. The Consensus Development Panel listened to presentations and participated in discussions. Independent workgroups of clinicians, scientists, and mental health advocates considered the evidence and prepared preliminary statements. Workgroup leaders presented drafts for discussion by the Consensus Development Panel. The final document was reviewed by the entire group and edited to incorporate input from all participants. Evidence suggests high rates of unmet needs for children and adolescents with depression or bipolar disorder. Training is largely limited to child mental health specialists; general psychiatrists, pediatricians, and other primary care physicians receive little or no training. As a result, treatment patterns may reflect adult treatment plans that are not validated for youths. Effective treatments have been identified and some preliminary prevention models have been developed, but they are not yet widely applied. Patients experience limited exposure to clinicians adequately trained to address their problems and little information to guide care decisions, particularly concerning bipolar disorder. National efforts are required to restructure healthcare delivery and provider training and to immediately develop more advanced research on pathophysiology, prevention, and services delivery effectiveness.

Practitioner review: psychological management of anxiety disorders in childhood.

Many anxiety problems begin in childhood and are a common form of psychological problem that can be highly distressing and associated with a range of social impairments. Thus, skills for conceptualising, assessing, and treating childhood anxiety problems should be in the repertoire of all child mental health specialists. This paper reviews psychosocial treatments for the most common anxiety disorders in children and adolescents. Developmental models of anxiety disorders emphasise maximum risk in children with shy or inhibited temperaments who are exposed to high family anxiety and avoidance, and/or acutely distressing experiences. As children mature these temperamental and environmental experiences are internalised to low self-competence and high threat expectancy. Both individual or group-based interventions utilising cognitive-behavioural strategies to address multiple risk factors are highly efficacious and family involvement can contribute to positive outcomes. Guidelines for assessment and treatment are presented, and suggestions are made for effectively managing clinical process.

Child and Adolescent Mental Health Needs Assessment and Service Implications in an Inner City Area

A random sample of 253 parents and young people were interviewed to elicit: (i) the number, type and severity of psychosocial problems in children/young people; and (ii) the number and type of risk factors for mental health in a very deprived inner city locality. The results suggest high levels of need for mental health services, with, for example, 37% of children having three or more problems, and over 51% having three or more risk factors. From subjective case-by-case analysis, preliminary criteria were derived for judging the level of required service response and the numbers likely to present appropriate to the various tiers of service. Of the 25% of the sample expressing a need for help, 6% were judged to be manageable by community staff (e.g. health visitors) with support from child mental health specialists, 4% by specially trained community staff (e.g. parent advisers), 8% by solo child and adolescent mental health specialists and 7% by generic or specialist child mental health teams.

Children and the legal process: Views from a Mental Health Clinic

Abstract The article reports on a pilot study carried out at a London mental health clinic during which child psychiatrists and child psychotherapists were interviewed about their experiences of and attitudes towards the courts and legal system. Thepurpose of the interviews was to determine whether evidence existed to support the view of child welfare science and law as two separate, self-referential discourses. During the interviews the mental health professionals expressed serious concerns about the way in which the legal system operated in children's cases and of the roles that they were obliged to play within that system. They emphasised the game-like nature of the process which did little to promote children's interests. The interviews gave some support to the notion of separate discourses by drawing uttention to the conceptual gap that exists between the perspectives of child mental health specialists and lawyers-a conclusion which does not augur well for the introduction of the Children Act 1989.

The impact of cumulative trauma in infancy: Some treatment techniques

Children who have had major disruptions and traumas in early developmental phases come to the attention of child mental health specialists frequently. These children present a complex and often puzzling picture due to the early deficits. Without skilled intervention further development will be hampered. Particular focus is placed on the individuation process in the first two years of life and its impact on early development of affects and object relations. Theoretical considerations and specific intervention techniques applying this model are delineated in two case reports.

A model training program for child mental health specialists.

The Child Mental Health Specialist Training Program was established in 1970 at Camarillo State Hospital to train personnel specifically for work with mentally disturbed and delinquent children in a variety of settings. In collaboration with local colleges, the two-year program offers training at the master's-, bachelor's-, and associate-degree levels. Its focus is on clinical experience, supplemented by academic courses taught by staff of the Camarillo Children's Treatment Center. The authors describe the growing need for qualified child-care workers, the concepts underlying the program's structure, and the operation of the program. They emphasize the importance of designing training programs to produce versatile and flexible workers with skills that are adaptable to changing treatment approaches.

The need and some specific suggestions for a standardized training program for a new professional: The child mental health specialist

The need and some specific suggestions for a standardized training program for a new professional: The child mental health specialist

The Child Mental Health Specialist: a new profession.

The necessity for personnel especially trained in child care, education, and clinical management is discussed, and formulation of a specific training program for Child Mental Health Specialists at the Camarillo Children's Treatment Center, in collaboration with a nearby college and junior college, is described.