Pediatric Consultation-Liaison Psychiatry Approach to Optimize Global Access to Child and Adolescent Mental Healthcare
Children and adolescents in many parts of the world are unable to access much-needed mental health services for various reasons, including a general lack of trained personnel, unaffordability of services, a lack of awareness, and sometimes, stigma. Mental health problems in children are often first identified by non-mental health professionals who may be pediatricians, general practitioners, or primary care workers. Children receiving care in medical, surgical or emergency wards, or for chronic physical illnesses, often experience psychiatric symptoms. These facts reveal a potential role for psychiatric liaison services in the care of children with mental health needs where other health problems may have been the original focus of care.
Addressing such mental health needs is challenging. Pediatric psychosomatic or child psychiatric consultation-liaison practitioners work at the interface between primary and mental health, and may work collaboratively to address the child’s needs holistically. In more resource-constrained settings, effective interventions may involve the transfer of essential skills for mental health assessment and management to non-psychiatric personnel, or the development of partnerships between psychiatrists and paediatricians, general practitioners, and other health workers, such as in a collaborative care model. Amidst a variety of challenges to collaboration and effective task shifting, including differences in professional training and approach, communication barriers, funding challenges, and logistical difficulties, there is a need for creativity in working within the challenges of each setting to provide mental health care for children who require it, while addressing their other health problems.
KeywordsLiaison psychiatry Collaborative care Task shifting Child psychiatric emergencies Pediatric psychosomatic Global mental health
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