Pediatric Consultation-Liaison Psychiatry Research Articles

Building Bridges: Collaborative Curriculum Development in Pediatric Consultation-Liaison Psychiatry

Building Bridges: Collaborative Curriculum Development in Pediatric Consultation-Liaison Psychiatry

6.1 Competencies and Training Needs Assessment in Pediatric Consultation-Liaison Psychiatry

6.1 Competencies and Training Needs Assessment in Pediatric Consultation-Liaison Psychiatry

12.3 East Meets West: Building the Foundations of Pediatric Consultation-Liaison Psychiatry in a Culturally Diverse Setting

Pediatric consultation-liaison (CL) psychiatry is a growing field globally. This presentation will share strategies and lessons learned while starting a pediatric psychiatry CL program in a culturally diverse environment with high stigma toward mental healthcare.

SIMON WILE SYMPOSIUM: PIVOTING IN THE PANDEMIC FOR PEDIATRIC CONSULTATION-LIAISON PSYCHIATRY SERVICES

The goal of this year’s Simon Wile Symposium is to explore innovative strategies to adjust systems and services addressing pediatric mental health challenges in hospital settings during the COVID-19 pandemic. Pediatric mental health needs climbed significantly during the pandemic, and pediatric consultation-liaison psychiatry services (PCLPS) have been at the forefront of addressing these needs in our community health systems. They have also been critical in supporting emotional health and well-being of fellow healthcare workers.

Training Needs Assessment Survey in Pediatric Consultation-Liaison Psychiatry.

Despite growing recognition of how curriculum modules can benefit child and adolescent psychiatry (CAP) training, there are few standardized teaching resources for pediatric consultation-liaison psychiatry (PCLP). A Special Interest Group (SIG) of the American Academy of Child and Adolescent Psychiatry Physically Ill Child Committee (PICC) conducted a needs assessment to establish interest in, and availability of, a library of online, self-paced learning modules specific to PCLP. An email needs assessment survey was distributed to the PICC listserv in the fall of 2019 with four core areas of inquiry: (1) clinical service description, (2) teaching barriers, (3) interest in curriculum resources, and (4) interest in evaluation resources. Respondents were representative of typical academic PCLP programs. The response rate was 28% (n = 39). Programs endorsed barriers to teaching including high service obligations and limited protected teaching time. All respondents indicated that they would utilize high-quality, online learning modules. Psychiatric complications of medical illness, catatonia, and delirium were identified as priority topics in the care of pediatric patients with comorbid medical conditions. There are currently no published educational studies regarding the training needs for PCLP programs, even among tertiary care academic facilities. This training needs assessment is the first step in establishing a national PCLP training curriculum. New paradigms to develop standardized curriculum resources for PCLP are needed.

Pediatric Consultation-Liaison Psychiatry—Yesterday, Today, and Tomorrow

Pediatric Consultation-Liaison Psychiatry—Yesterday, Today, and Tomorrow

Adaptations Made to Pediatric Consultation-Liaison Psychiatry Service Delivery During the Early Months of the COVID-19 Pandemic: A North American Multisite Survey.

BackgroundThe COVID-19 pandemic led to rapid changes in clinical service delivery across hospital systems nationally. Local realities and resources were key driving factors impacting workflow changes, including for pediatric consultation-liaison psychiatry service (PCLPS) providers.ObjectiveThis study aims to describe the early changes implemented by 22 PCLPSs from the United States and Canada during the COVID-19 pandemic. Understanding similarities and differences in adaptations made to PCLPS care delivery can inform best practices and future models of care.MethodsA 20-point survey relating to PCLPS changes during the COVID-19 pandemic was sent to professional listservs. Baseline hospital demographics, hospital and PCLPS workflow changes, and PCLPS experience were collected from March 20 to April 28, 2020, and from August 18 to September 10, 2020. Qualitative data were collected from responding sites. An exploratory thematic analysis approach was used to analyze the qualitative data that were not dependent on predetermined coding themes. Descriptive statistics were calculated using Microsoft Excel.ResultsTwenty-two academic hospitals in the United States and Canada responded to the survey, with an average of 303 beds/hospital. Most respondents (18/22) were children's hospitals. Despite differences in regional impact of COVID-19 and resource availability, there was significant overlap in respondent experiences. Restricted visitation to one caregiver, use of virtual rounding, ongoing trainee involvement, and an overall low number of COVID-positive pediatric patients were common. While there was variability in PCLPS care delivery occurring virtually versus in person, all respondents maintained some level of on-site presence. Technological limitations and pediatric provider preference led to increased on-site presence.ConclusionsTo our knowledge, this is the first multicenter study exploring pandemic-related PCLPS changes in North America. Findings of this study demonstrate that PCLPSs rapidly adapted to COVID-19 realities. Common themes emerged that may serve as a model for future practice. However, important gaps in understanding their effectiveness and acceptability need to be addressed. This multisite survey highlights the importance of establishing consensus through national professional organizations to inform provider and hospital practices.

Core Competencies for Pediatric Consultation-Liaison Psychiatry in Child and Adolescent Psychiatry Fellowship Training

Learners developing competency-based skills, attitudes, and knowledge through the achievement of defined milestones is a core feature of competency-based medical education. In 2017, a special interest study group of the American Academy of Child and Adolescent Psychiatry convened a panel of specialists to describe pediatric consultation-liaison psychiatry (CLP) best educational practices during child and adolescent psychiatry fellowship. The objective of this project was to develop a national consensus on pediatric CLP competencies to help guide training in this specialty. An expert working group developed a list of candidate competences based on previously established educational outcomes for CLP (formerly Psychosomatic Medicine), child and adolescent psychiatry, and general psychiatry. A survey was distributed to members of the American Academy of Child and Adolescent Psychiatry Physically Ill Child Committee to determine child and adolescent psychiatry fellowship educational needs on pediatric CLP services and generate consensus regarding pediatric CLP competencies. Most survey respondents were supportive of the need for a national consensus on core competencies for pediatric CLP. Consensus from a panel of experts in the field of pediatric CLP generated a list of proposed core competencies that track the Accreditation Council for Graduate Medical Education's six core competencies. Consistent learning outcomes provide the foundation for further development of tools to support training in pediatric CLP. There is a need to develop further tools including outcome assessment instruments and self-directed learning materials that can be used to support lifelong learning.

1.59 Addressing Mental Health Stigma: A Pilot Educational Video Intervention for Caregivers to Facilitate Pediatric Consultation-Liaison Psychiatry Involvement in the Inpatient Medical Setting

Stigma in pediatric mental health continues to be a significant barrier for youth to receive much-needed mental health care. Parents’ misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with mental health occurs during medical hospitalization when they are seen by the pediatric psychiatry consultation-liaison (C/L) service. Despite this unique role, there is sparse research on how to address mental health stigma with patients and families within the context of pediatric C/L psychiatry.

58.5 Shared Experience of Developing Pediatric Consultation Liaison Psychiatry in Singapore

In Singapore, the development of Pediatric Consultation Liaison Psychiatry (PCLP) has historically been limited by the health organizational structure and availability of child and adolescent psychiatry services. This study explores the mental health needs of children and adolescents admitted into the country’s largest pediatric hospital, Kerbang Kerbau Women’s and Children’s Hospital (KKWCH), and the development of a child and adolescent mental wellness service (CAMWS) since 2010.

A study of pediatric consultation liaison psychiatry (PCLP) clinicians’ activities

A study of pediatric consultation liaison psychiatry (PCLP) clinicians’ activities

Developing quality improvement programs in pediatric consultation-liaison psychiatry

Developing quality improvement programs in pediatric consultation-liaison psychiatry

Practice Patterns in Pediatric Consultation–Liaison Psychiatry: A National Survey

The purpose of this survey was to describe the current status of pediatric consultation-liaison (C-L) services in the United States. A total of 144 pediatric C-L programs were surveyed, with a response rate of 33%. Financial and staffing constraints were cited as common problems; 61% of programs reported an increase in consultation requests over the past 5 years, however, 30% of services reported a decrease in funding. Collection rates for professional billings average 30%; 57% of services reported an increase in clinical service demands at the expense of teaching and liaison activities. Discussion includes recommendations based on the results of the survey.

Consultation-Liaison in Child Psychiatry: A Review of the Past 10 Years. Part I: Clinical Findings

To critically review clinical reports on pediatric consultation-liaison psychiatry over the past 10 years. Articles contributing to the understanding of child psychiatric consultation in medical settings were reviewed. Information related to clinical issues was organized into categorical (disease-oriented), noncategorical, and family studies. Newer articles on ethical considerations in caring for medically ill children are summarized. Research has continued to focus on and reflect the importance of the emotional and behavioral needs of children in pediatric settings and the adaptation and stress within families who care for chronically ill children. Given the increased complexity and demands of medical care, the training and skills of a child psychiatrist in pediatric consultation remain a valuable component of comprehensive care for children.

Ethical Issues in Pediatric Consultation-Liaison

General principles of medical ethics are outlined as a basis for discussion of ethical issues in pediatric consultation-liaison psychiatry. Modern ethics is rooted in philosophical soils that extend across a wide intellectual terrain, from ideologic ethical systems such as rule utilitarianism and act utilitarianism to deontologic systems, exemplified by the categoric imperative. Differences between the conclusions pointed to by these systems give rise to the potential tensions among concepts of patient autonomy, physician beneficence, and distributive justice. The roles of the child psychiatrist consulting to pediatrics are reviewed. Using six clinical vignettes, several ethical issues and the child psychiatrist‘s response to them are explored. These are analyzed in relation to the underlying ethical theory.

Book Review: Pediatric Consultation Liaison Psychiatry.

Book Review: Pediatric Consultation Liaison Psychiatry.