Mental disorders in minors during the COVID-19 pandemic

Kölch, Michael; Reis, Olaf; Ulbrich, Lisa; Schepker, Renate

doi:10.3238/arztebl.m2023.0010

Cited by 8 publications

(10 citation statements)

References 3 publications

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“…Four studies analysed large databases that included the reporting of MH admissions and discharges (19,20,25,27). Using the Paediatric Health Information database Plemmons et al (27) identified, between 2008 and 2015, 115,856 SA and suicidal ideations (SI) encounters across 31 hospitals of which 67,588 resulted in an inpatient hospitalization in a children’s hospital.…”

Section: Resultsmentioning

confidence: 99%

“…However, CYP discharges ages 6-13 years rose significantly (26.7% [5,727/21,450] in 1990 vs 34.4% [10,179/29,590] in 2000; p<0.001). Finally, Kölch et al (25) analysed data for MH admissions in CYP from Germany, comparing the first six months of 2019 (pre-pandemic) and of 2021 (during the pandemic). They found no change in the number of admissions to specialist MH inpatient care for CYP with anxiety disorders or obsessive-compulsive disorders between time points.…”

Section: Resultsmentioning

confidence: 99%

“…Detailed findings of the included studies are collated in Tables 1-4. Eighteen studies addressed trends and or numbers/proportions of admissions (3,4,(6)(7)(8)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), 12 provided data about HCPs views/experiences (4,(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41), two provided data about CYP views/experiences (37,42) and four aimed at improving the care during admissions (6,40,43,44).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Four studies analysed large databases that included the reporting of MH admissions and discharges (19,20,25,27). Using the Paediatric Health Information database Plemmons et al (27) (20) reported that care for SA patients (n= 32,655) was provided in adult hospitals (83.3%), children's units (10.2%) and children's hospitals (4.4%).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…We assessed fifteen studies using the AXIS scale (Table S2). In 11 studies (73%) it was unclear what methods were used to determine the sample size (7,8,18,(21)(22)(23)(24)(25)28,29,32). Only one study (7%) provided clear information about the measurements undertaken to address non-response (22), and none reported clear information about concerns around non-response bias.…”

Section: Hcps' Experiencesmentioning

confidence: 99%

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‘Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature’

Vázquez-Vázquez,

Smith,

Gibson

et al. 2023

Preprint

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ObjectiveTo systematically review the literature describing children and young people (CYP) admissions to paediatric general wards because of primary mental health reasons, particularly in MH crisis.DesignPubMed, Embase, PsychINFO, Web of Science and Google Scholar were searched. We addressed five search questions to inform: trends and/or the number of admissions, the risk factors for adverse care, the experiences of CYP, families/carers and health care professionals (HCPs) and the evidence of interventions aimed at improving the care during admissions.Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality assessment. This review was registered with Prospero (CRD42022350655).ResultsThirty-two studies met the inclusion criteria. Eighteen addressed trends and or numbers/proportions of admissions, 12 provided data about the views/experiences of HCPs, two provided data about CYPs’ experiences and four explored improving care. We were unable to identify studies examining risk factors for harm during admissions, but studies did report the length of stay in general paediatric/adult settings while waiting for specialised care, which could be considered a risk factor while caring for this group.ConclusionsMH admissions to children’s wards are a long-standing issue and are increasing. CYP will continue to need to be admitted in crisis, with paediatric wards a common allocation whilst waiting for assessment. For services to be delivered effectively and for CYPs and their families/carers to feel supported and HCPs to feel confident, we need to facilitate more integrated physical and MH pathways of care.What is already known on this topic?-There is evidence that both the number of paediatric admissions and the severity of MH crisis in CYP have increased. Children’s wards are not designed to treat CYP with MH problems and HCPs haven’t had enough training.-There is no published systematic review on this topic.What this study adds?-This is the first systematic review on CYP admissions to paediatric wards with a primary MH indication.-Evidence suggested increased numbers of admissions to paediatric wards over time. HCPs reported concerns about skill sets to manage CYP with MH presentations and questioned the appropriateness of the acute ward for this care.-There is limited evidence on CYP experiences during admissions and on studies to improve care. We found no evidence of specific risk factors for adverse care for CYP and families/carers during admissions and no studies on families/carers’ experiences.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Four studies analysed large databases that included the reporting of MH admissions and discharges (19,20,25,27). Using the Paediatric Health Information database Plemmons et al (27) (20) reported that care for SA patients (n= 32,655) was provided in adult hospitals (83.3%), children's units (10.2%) and children's hospitals (4.4%).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Section: Hcps' Experiencesmentioning

confidence: 99%

See 3 more Smart Citations

‘Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature’

Vázquez-Vázquez,

Smith,

Gibson

et al. 2023

Preprint

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Die Versorgungslandschaft der Kinder- und Jugendpsychiatrie und -psychotherapie in Deutschland: Strukturen, Herausforderungen und Entwicklungen

Schepker

Kölch

2023

Bundesgesundheitsbl

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ZusammenfassungFür die psychiatrische und psychotherapeutische Versorgung von Kindern und Jugendlichen gibt es in Deutschland ambulante, teilstationäre und stationäre Einrichtungen. Eine neue Entwicklung ist die stationsäquivalente Behandlung (StäB), bei der die Patientinnen und Patienten durch ein multiprofessionelles Team in ihrem sozialen Umfeld versorgt werden. In diesem Beitrag wird ein Überblick über die Versorgungslandschaft für psychisch erkrankte Kinder und Jugendliche gegeben. Dabei wird auf geschichtliche Hintergründe sowie auf strukturelle, versorgungspolitische und ökonomische Zusammenhänge eingegangen.Bis zum Jahr 2014 herrschte im ambulanten Sektor Niederlassungsfreiheit, was dazu führte, dass ländliche Gegenden und sozioökonomisch benachteiligte Stadtteile bis heute teilweise unterversorgt sind. Im Krankenhaussektor nahm zwischen 1991 und 2004 die Bettenzahl stark ab und danach zugunsten besserer Regionalisierung mit kleinen Einheiten und kleinen Stationen wieder deutlich zu, ergänzt durch überproportional gewachsene Tagesklinikplätze. Stationsäquivalente Behandlungen sind ebenso effektiv, aber noch nicht flächendeckend etabliert, Modellvorhaben nur wenige verhandelt. Regionale Vernetzungen aller Hilfesysteme bis hin zu anzustrebenden jugendpsychiatrischen Verbünden erfahren in der Versäulung des Sozialsystems liegende Begrenzungen. Als Fazit wären ein Kooperationsgebot über die Sozialgesetzbücher hinweg und die Ermöglichung wahrer sektorenübergreifender Versorgung wünschenswert.

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Wie sichern wir in Zukunft die Versorgung von Kindern und Jugendlichen mit psychischen Erkrankungen?

Romanos,

Berg,

Brauer

et al. 2024

Bundesgesundheitsbl

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ZusammenfassungKinder und Jugendliche mit psychischen Störungen weisen komplexe Bedarfe auf, die regelhaft Leistungen aus mehreren Sozialgesetzbüchern erforderlich machen und innerhalb der medizinischen Versorgung Leistungen aus verschiedenen Sektoren bedingen können. Die steigende Inanspruchnahme, die Zunahme der Schweregrade der Störungsbilder sowie der fachübergreifende Personalmangel belasten die Strukturen der interdisziplinären Versorgungsnetzwerke. Die Folge sind lange Wartezeiten, lange Wegstrecken und regionale Unterversorgung. Das Fachgebiet der Kinder- und Jugendpsychiatrie und -psychotherapie (KJPP) nimmt die zentrale und koordinative Rolle in der kooperativen Versorgung von Kindern und Jugendlichen mit psychischen Erkrankungen ein. Die KJPP weist angesichts der zunehmenden Herausforderungen Reformbedarf auf, welcher sich von dem der somatischen Versorgungsstrukturen, aber ebenso von denen der Psychiatrie und Psychotherapie bzw. der Psychosomatik unterscheidet. Das vorliegende Diskussionspapier beschreibt die Besonderheiten der KJPP-Strukturen, die Reformbedarfe und Lösungsmöglichkeiten durch Abbau von Sektorengrenzen in der Patientenversorgung, in der Weiterbildung sowie im Personaleinsatz, durch Intensivierung der Vernetzung, durch stärkere Nutzung von Telemedizin sowie durch Aufbau evidenzbasierter Prävention und Früherkennung.

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Mental disorders in minors during the COVID-19 pandemic

Cited by 8 publications

References 3 publications

‘Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature’

‘Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature’

Die Versorgungslandschaft der Kinder- und Jugendpsychiatrie und -psychotherapie in Deutschland: Strukturen, Herausforderungen und Entwicklungen

Wie sichern wir in Zukunft die Versorgung von Kindern und Jugendlichen mit psychischen Erkrankungen?

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