Abstract:
Based in the multicultural context of Montreal, Quebec, Canada, this article reviews Shared Care and Collaborative Care models which privilege consultations between primary and specialty care in children’s mental health. An overview of Canada’s two largest child psychiatric epidemiological studies outlines the nonclinical community prevalence in Ontario (18.5%) and Quebec (15%) of children’s mental health problems along with salient family and community risk factors. Given the high prevalence of children’s mental health problems and the burden of care undertaken by primary care practitioners, the interface between the first line of care and mental health services is crucial yet often characterized by poor communication, a lack of mutual comprehension, and limited collaboration.[1] Collaborative mental health care has been defined as "a family physician or other primary care provider working together with a psychiatrist or other mental health worker in a mutually supportive partnership.”[1] This definition is extended to describe a spectrum of partnerships in Child and Adolescent Psychiatry (CAP): Shared Care, Collaborative Care, and related collaborative community practices. The author’s experience with these models is presented with an overview of a pilot study on CAP Shared Care in Montreal.[2] Two other recent trends in Quebec are explored: an innovation called “Medical Specialists Responding in Child and Adolescent Psychiatry” (MSRCAP) for community mental health care teams and the pair aidant or “peer helper” model reaching out to patients and families with a member who suffers from mental health problem to serve as a helper, a model, and part of the support network.
Key Words: children’s mental health, psychiatric epidemiology, shared care, collaborative care, community consultations
Special issue on Child & Adolescent Psychiatry, World Social Psychiatry [serial online] 2022 [cited 2022 Aug 22];4:78-84. Available from: https://www.worldsocpsychiatry.org/text.asp?2022/4/2/78/354177
DOI: 10.4103/wsp.wsp_19_22
Published in ―Theory and Practice of Clinical Social Work (2.docxamrit47
Published in ―Theory and Practice of Clinical Social Work (2
nd
Edition), J. Brandell,
Ed., Columbia University Press, 2010.
2200
CLINICAL CASE MANAGEMENT
Joel Kanter
Over the past 30 years, case management has become a ubiquitous intervention
approach throughout the mental health and health care fields. Often poorly defined, case
management, perhaps a linguistic repackaging of ―social work‖ or ―social casework,‖
encompasses a wide range of environmental interventions with persons in need,
including persons suffering from severe mental illness, substance abuse, and chronic
medical conditions such as HIV, tuberculosis, and diabetes. In health care, the term case
management can refer to cost-conscious telephone interventions to monitor medical
services or to discharge planning from an inpatient facility. In mental health, case
management may refer to helping a client obtain disability benefits or apply for housing
assistance. Or it may refer to a friendly paraprofessional visitor who assists with
homemaking and transportation.
Addressing these disparate needs, an array of case management models have
been identified and articulated: brokerage, rehabilitation, strengths based, and clinical.
Other adjectives have been frequently used to characterize less specific case
management interventions: ―intensive,‖ ―assertive,‖ and ―standard.‖ Understanding the
case management literature often requires readers to carefully examine details of the
actual interventions and human resource issues to determine what the term case
management means in each situation.
Were the interventions short-term or long-term?
Were the relationships between case managers and clients personal or
administrative?
Was ―case management‖ the main activity of the worker or one of an array
of interventions?
What were the duration and frequency of case management contacts?
Were the scope of case management interventions focused on clients
holistically or were they narrowly focused on a single illness or life domain?
How large were case managers‘ caseloads?
Did case managers address the interplay between psychological and
environmental concerns?
What was the professional training and experience of the case managers?
In this chapter, the focus will be on a specific case management model—clinical
case management—that addresses the above questions with more clarity than other
approaches. In a clinical case management approach, relationships with clients are
valued, interventions are holistically focused, and case managers recognize the interplay
between psychological and environmental domains. Clinical case management can be
defined as a modality of social work practice that, acknowledging the importance of
biological and psychological factors, addresses the overall function and maintenance of
the person‘s physical and social environment toward the goals of facilitating physical
surv ...
Published in ―Theory and Practice of Clinical Social Work (2.docxamrit47
Published in ―Theory and Practice of Clinical Social Work (2
nd
Edition), J. Brandell,
Ed., Columbia University Press, 2010.
2200
CLINICAL CASE MANAGEMENT
Joel Kanter
Over the past 30 years, case management has become a ubiquitous intervention
approach throughout the mental health and health care fields. Often poorly defined, case
management, perhaps a linguistic repackaging of ―social work‖ or ―social casework,‖
encompasses a wide range of environmental interventions with persons in need,
including persons suffering from severe mental illness, substance abuse, and chronic
medical conditions such as HIV, tuberculosis, and diabetes. In health care, the term case
management can refer to cost-conscious telephone interventions to monitor medical
services or to discharge planning from an inpatient facility. In mental health, case
management may refer to helping a client obtain disability benefits or apply for housing
assistance. Or it may refer to a friendly paraprofessional visitor who assists with
homemaking and transportation.
Addressing these disparate needs, an array of case management models have
been identified and articulated: brokerage, rehabilitation, strengths based, and clinical.
Other adjectives have been frequently used to characterize less specific case
management interventions: ―intensive,‖ ―assertive,‖ and ―standard.‖ Understanding the
case management literature often requires readers to carefully examine details of the
actual interventions and human resource issues to determine what the term case
management means in each situation.
Were the interventions short-term or long-term?
Were the relationships between case managers and clients personal or
administrative?
Was ―case management‖ the main activity of the worker or one of an array
of interventions?
What were the duration and frequency of case management contacts?
Were the scope of case management interventions focused on clients
holistically or were they narrowly focused on a single illness or life domain?
How large were case managers‘ caseloads?
Did case managers address the interplay between psychological and
environmental concerns?
What was the professional training and experience of the case managers?
In this chapter, the focus will be on a specific case management model—clinical
case management—that addresses the above questions with more clarity than other
approaches. In a clinical case management approach, relationships with clients are
valued, interventions are holistically focused, and case managers recognize the interplay
between psychological and environmental domains. Clinical case management can be
defined as a modality of social work practice that, acknowledging the importance of
biological and psychological factors, addresses the overall function and maintenance of
the person‘s physical and social environment toward the goals of facilitating physical
surv ...
Developing non-clinical approaches and are pathways to fundamental socioeconomic issues that are presented in the primary care and secondary care settings
Lesson 10 Integrated mental healthhealthcare and future of menta.docxSHIVA101531
Lesson 10: Integrated /mental health/healthcare and future of mental health services in public sector
Readings:
Schuffman, D., Druss, B.G., & Parks, J.J. (2009). Mending Missouri’s safety net: Transforming systems of care by integrating primary and behavioral health care. Psychiatric Services, 60(5), 585-588.
Hogan MF, Sederer LI, Smith TE, & Nossel IR. (2010). Making room for mental health in the medical home. Prev. Chronic Dis. 7(6):A132 [Erratum appears in Prev Chronic Dis 2010;8(1). http://www.cdc.gov/pcd/issues/2011/jan/10_0249.htm.]
Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376-382. http://content.healthaffairs.org/content/31/2/376.short
View the short video on the Health Resources and Services Administration (HRSA) website about a primary care program in Tennessee. Available at: http://www.hrsa.gov/publichealth/clinical/BehavioralHealth/
Introduction
Goal 1 of the President’s New Freedom Commission Report states that: “Americans understand that mental health is essential to overall health.” This seems like a simple enough goal. It is, however, not as easy to achieve as it appears.
The link between mental and physical health has long been a subject of interest to theorists and practitioners and has been studied in the general population. For example, in a general population study, Sederer et al. (2006) found that those New Yorkers who reported nonspecific psychological distress suffered more physical health problems, were more likely to smoke, be inactive and have a poor diet than those who didn’t report distress. They noted that these individuals were much more likely to have hypertension, hyperlipidemia, obesity, asthma, and diabetes.
The link with physical health is especially important for those suffering from serious mental illness. We learned in a previous lesson that persons with serious mental illness were likely to die 25 years earlier than adults in the general population (Colton & Manderscheid, 2006). Of those who die, 87% do so because of medical illnesses (Parks, Radke, & Mazade, 2008). These studies, results from Sederer et al. in a general population, and others show that physical and psychological problems not only co-exist, but also have a relationship. Treating one without addressing the other will result in inadequate care for the individual who suffers from both. Not much in terms of practice, however, has been done to address this issue until fairly recently.
Why Integrate Care?
Addressing the physical health needs of persons with mental illness has become increasingly important as more evidence becomes available of the link between them. An account of a recently held forum at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care noted:
“For years, the prevailing notion in medicine held that the body is treated in a physician's office and the mind in a ...
Community Wellbeing - What has Social Prescribing got to offer Public Health
IPH, Open, Conference, Belfast, Northern, Ireland, Dublin, Titanic, October, 2014, Public, Health
Read and respond to each peer initial post with 3-4 sentence long re.docxniraj57
Read and respond to each peer initial post with 3-4 sentence long response
Peer #1
For the Research Assignment, I have chosen to focus on an area of Healthcare that rarely gets the
attention it deserves.
Mental health.
I
chose this topic because I am personally effected by it and so are many millions of Americans. Mental illness is also one of the leading causes of
death in our nation and one life is lost as a result of suicide, abuse or incarceration every 17mins in the United States. Mental illness has been my
area of focus throughout this program and the advocacy and participatory philosophy will be useful for the final project because it suggests that
“
that research inquiry needs to be intertwined with politics and a political agenda” (Creswell, p.9). I do believe that mental health has a specific
agenda for a study and that there has been constant aim for reform in healthcare and mental health. This social issue is definitely pertinent right
now and topics that address it such as “empowerment, inequality, oppression, domination, suppression, and alienation” (Creswell, p.9), and are
really the focus of the study. The goal of this project for me, is to provide a voice to participants and give them the ability address the concerns that
will lead to reform.
According to Kemmis and Wilkinson (1998) this philosophy offers four key features of the advocacy/participatory framework of inquiry:
1. Participatory actions are focused on bringing about change, and at the end of this type of study, researchers create an action agenda for change.
2. It is focused on freeing individuals from societal constraints, which is why the study begins with an important issue currently in society.
3. It aims to create a political debate so that change will occur.
4. Since advocacy/participatory researchers engage participants as active contributors to the research, it is a collaborative experience.
Research Problem Statement
My Vision is to Provide members of the community with the opportunities and education needed to prevent death due to suicide, acts of self-harm
and the traumatic impact of mental illness. By promoting resilience, the enhancement of community resources, conflict resolution and support for
individuals, families and the communities of those who suffer with mental disorders, illness or have a sudden mental health crisis. The target
population includes all individuals within Chatham County, with unmet mental health needs.
These individuals are currently not being served by
traditional methods due to financial, structural, and personal barriers including access and stigma. Untreated mental health
issues of these
individuals put them at risk for exacerbation of physical health problems, suicide attempts, premature moves to long-term care settings, and
psychiatric hospitalization, incarceration, residential alcohol/drug treatment or homelessness. The target population is all individuals within
Chatham County, ...
Abstract:
It is difficult to find in Spanish a word that can translate the meaning of Counselling and encompassing all those elements and nuances that you are your own. The translations more frequently used are "assisted advice" and/or "aid relationship" and/or advice, it also includes all the skills that are necessary to establish that interpersonal relationship.
Although the communication skills, and in particular communication of bad news and the relationship with users are currently not part of the university education within the degree in Medicine, Nursing, Physiotherapy or Psychology if it has been of concern on the part of practitioners in these areas present sufficient levels of training in this core competency. In fact, we presented/displayed a communication where the little information received in the own hospital on the part of parents with children with Syndrome of Down is reflected in particular on this genetic alteration before making decisions referred to the birth from the boy. Thus, just as the curative art is learned can be learned the abilities of communication referred the unexpected news, which will help to diminish the psychological cost for the professional and the own patient.
My contention as a social psychiatrist and social philosopher is that the foundations of psychology and psychiatry—and the edifices that are built upon them, from theories to research paradigms to therapeutic interventions—are precisely upside down. Starting with the self, the individual, person, and mind is to start building the roof rather than the foundations of a structure. In the social sciences (such as anthropology, psychology, sociology) and the humanities (from literature to philosophy) it is wiser to start with society, the group, the collective, and relations, then move to the individual, mind, and self.
The Social Determinants of Health – Social Psychiatry’s Basic ScienceUniversité de Montréal
Psychiatric Times
Home page teaser: From populations to patients.
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/-the-web-of-meaning-family-therapy-is-social-psychiatrys-therapeutic-branch
The Social Determinants of Health – Social Psychiatry’s Basic Science
May 29, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No disciple of the wise may live in a city that does not have a physician, a surgeon, a bathhouse, a lavatory, a source of water, a synagogue, a school teacher, a scribe, a treasurer of charity funds for the poor, a court that has authority to punish.
—Moses Maimonides1
In this column, I want to highlight our first, foundational branch of social psychiatry – psychiatric epidemiology and public mental health by focusing on the Social Determinants of Health (SDoH). I consider SDoH the basic science of social psychiatry.
More Related Content
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Developing non-clinical approaches and are pathways to fundamental socioeconomic issues that are presented in the primary care and secondary care settings
Lesson 10 Integrated mental healthhealthcare and future of menta.docxSHIVA101531
Lesson 10: Integrated /mental health/healthcare and future of mental health services in public sector
Readings:
Schuffman, D., Druss, B.G., & Parks, J.J. (2009). Mending Missouri’s safety net: Transforming systems of care by integrating primary and behavioral health care. Psychiatric Services, 60(5), 585-588.
Hogan MF, Sederer LI, Smith TE, & Nossel IR. (2010). Making room for mental health in the medical home. Prev. Chronic Dis. 7(6):A132 [Erratum appears in Prev Chronic Dis 2010;8(1). http://www.cdc.gov/pcd/issues/2011/jan/10_0249.htm.]
Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376-382. http://content.healthaffairs.org/content/31/2/376.short
View the short video on the Health Resources and Services Administration (HRSA) website about a primary care program in Tennessee. Available at: http://www.hrsa.gov/publichealth/clinical/BehavioralHealth/
Introduction
Goal 1 of the President’s New Freedom Commission Report states that: “Americans understand that mental health is essential to overall health.” This seems like a simple enough goal. It is, however, not as easy to achieve as it appears.
The link between mental and physical health has long been a subject of interest to theorists and practitioners and has been studied in the general population. For example, in a general population study, Sederer et al. (2006) found that those New Yorkers who reported nonspecific psychological distress suffered more physical health problems, were more likely to smoke, be inactive and have a poor diet than those who didn’t report distress. They noted that these individuals were much more likely to have hypertension, hyperlipidemia, obesity, asthma, and diabetes.
The link with physical health is especially important for those suffering from serious mental illness. We learned in a previous lesson that persons with serious mental illness were likely to die 25 years earlier than adults in the general population (Colton & Manderscheid, 2006). Of those who die, 87% do so because of medical illnesses (Parks, Radke, & Mazade, 2008). These studies, results from Sederer et al. in a general population, and others show that physical and psychological problems not only co-exist, but also have a relationship. Treating one without addressing the other will result in inadequate care for the individual who suffers from both. Not much in terms of practice, however, has been done to address this issue until fairly recently.
Why Integrate Care?
Addressing the physical health needs of persons with mental illness has become increasingly important as more evidence becomes available of the link between them. An account of a recently held forum at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care noted:
“For years, the prevailing notion in medicine held that the body is treated in a physician's office and the mind in a ...
Community Wellbeing - What has Social Prescribing got to offer Public Health
IPH, Open, Conference, Belfast, Northern, Ireland, Dublin, Titanic, October, 2014, Public, Health
Read and respond to each peer initial post with 3-4 sentence long re.docxniraj57
Read and respond to each peer initial post with 3-4 sentence long response
Peer #1
For the Research Assignment, I have chosen to focus on an area of Healthcare that rarely gets the
attention it deserves.
Mental health.
I
chose this topic because I am personally effected by it and so are many millions of Americans. Mental illness is also one of the leading causes of
death in our nation and one life is lost as a result of suicide, abuse or incarceration every 17mins in the United States. Mental illness has been my
area of focus throughout this program and the advocacy and participatory philosophy will be useful for the final project because it suggests that
“
that research inquiry needs to be intertwined with politics and a political agenda” (Creswell, p.9). I do believe that mental health has a specific
agenda for a study and that there has been constant aim for reform in healthcare and mental health. This social issue is definitely pertinent right
now and topics that address it such as “empowerment, inequality, oppression, domination, suppression, and alienation” (Creswell, p.9), and are
really the focus of the study. The goal of this project for me, is to provide a voice to participants and give them the ability address the concerns that
will lead to reform.
According to Kemmis and Wilkinson (1998) this philosophy offers four key features of the advocacy/participatory framework of inquiry:
1. Participatory actions are focused on bringing about change, and at the end of this type of study, researchers create an action agenda for change.
2. It is focused on freeing individuals from societal constraints, which is why the study begins with an important issue currently in society.
3. It aims to create a political debate so that change will occur.
4. Since advocacy/participatory researchers engage participants as active contributors to the research, it is a collaborative experience.
Research Problem Statement
My Vision is to Provide members of the community with the opportunities and education needed to prevent death due to suicide, acts of self-harm
and the traumatic impact of mental illness. By promoting resilience, the enhancement of community resources, conflict resolution and support for
individuals, families and the communities of those who suffer with mental disorders, illness or have a sudden mental health crisis. The target
population includes all individuals within Chatham County, with unmet mental health needs.
These individuals are currently not being served by
traditional methods due to financial, structural, and personal barriers including access and stigma. Untreated mental health
issues of these
individuals put them at risk for exacerbation of physical health problems, suicide attempts, premature moves to long-term care settings, and
psychiatric hospitalization, incarceration, residential alcohol/drug treatment or homelessness. The target population is all individuals within
Chatham County, ...
Abstract:
It is difficult to find in Spanish a word that can translate the meaning of Counselling and encompassing all those elements and nuances that you are your own. The translations more frequently used are "assisted advice" and/or "aid relationship" and/or advice, it also includes all the skills that are necessary to establish that interpersonal relationship.
Although the communication skills, and in particular communication of bad news and the relationship with users are currently not part of the university education within the degree in Medicine, Nursing, Physiotherapy or Psychology if it has been of concern on the part of practitioners in these areas present sufficient levels of training in this core competency. In fact, we presented/displayed a communication where the little information received in the own hospital on the part of parents with children with Syndrome of Down is reflected in particular on this genetic alteration before making decisions referred to the birth from the boy. Thus, just as the curative art is learned can be learned the abilities of communication referred the unexpected news, which will help to diminish the psychological cost for the professional and the own patient.
My contention as a social psychiatrist and social philosopher is that the foundations of psychology and psychiatry—and the edifices that are built upon them, from theories to research paradigms to therapeutic interventions—are precisely upside down. Starting with the self, the individual, person, and mind is to start building the roof rather than the foundations of a structure. In the social sciences (such as anthropology, psychology, sociology) and the humanities (from literature to philosophy) it is wiser to start with society, the group, the collective, and relations, then move to the individual, mind, and self.
The Social Determinants of Health – Social Psychiatry’s Basic ScienceUniversité de Montréal
Psychiatric Times
Home page teaser: From populations to patients.
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/-the-web-of-meaning-family-therapy-is-social-psychiatrys-therapeutic-branch
The Social Determinants of Health – Social Psychiatry’s Basic Science
May 29, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No disciple of the wise may live in a city that does not have a physician, a surgeon, a bathhouse, a lavatory, a source of water, a synagogue, a school teacher, a scribe, a treasurer of charity funds for the poor, a court that has authority to punish.
—Moses Maimonides1
In this column, I want to highlight our first, foundational branch of social psychiatry – psychiatric epidemiology and public mental health by focusing on the Social Determinants of Health (SDoH). I consider SDoH the basic science of social psychiatry.
Psychiatric Times
Home page teaser: Embracing movement as theory
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May 22, 2024
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The migrant has become the political figure of our time.
– Thomas Nail, The Figure of the Migrant
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- King Lear, Act IV, sc 7
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Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No more fiendish punishment could be devised … than that one should be turned loose in society and remain absolutely unnoticed by the members thereof. – William James
Lead: Some of the most divisive notions in the Western world and the Global North: individualism and independence. Are they a myth?
DOI: 10.13140/RG.2.2.32192.14086
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2. These lessons integrate my work in psychiatry and psychotherapy with my Slow Thought Manifesto and my call for Slow Therapy
3. With these seven lessons for young therapists in this technocratic time of pressure and speed, I commend young therapists – eager to embrace change and to make a difference – to “Take your time”
4. By opening a space for reflection by every party in the therapeutic encounter, the possibility of an event – something surprising, unpredictable and new – may emerge
DOI: 10.13140/RG.2.2.32747.55841
“Atado a una rueda de fuego”: Reflexiones sobre una vida en los estudios de t...Université de Montréal
V Di Nicola, “Atado a una rueda de fuego”: Reflexiones sobre una vida en los estudios de trauma. Boletín CRISOL (Centro de Posgrado en Terapia Familiar), Febrero 2024, 1: pp. 3-6.
Abstracto
Este breve ensayo aborda el trauma desde tres perspectivas: psiquiatría infantil y familiar, atención informada sobre el trauma y psiquiatría y filosofía social. Se presenta brevemente la tragedia del Rey Lear como marco para comprender la tragedia y el trauma. Para terminar, el autor aboga por un enfoque matizado del trauma que sea selectivo pero que responda a las rupturas que crean trauma y tragedia en nuestras vidas.
Palabras clave: trauma, tragedia, Determinantes Sociales de la Salud (DSS), Experiencias Adversas en la Infancia (EAI), Trastornos de Estrés Postraumático (TEPT), historia de trauma
"El Evento Como Desencadenante del Cambio Ontólogico"
por Vincenzo Di Nicola
MASTER CLASS Practicum Internacional 2024
CRISOL Centro de Posgrado en Terapia Familiar Ciudad de México, México
8 y 9 de Marzo de 2024
DOI: 10.13140/RG.2.2.27104.90887
From Populations to Patients: Social Determinants of Health & Mental Health i...Université de Montréal
Abstract:
The overall objective of this webinar is to harness the powerful data of populational studies to patients in clinical practice.
This is effectively a plan for applying social psychiatry to the clinic –a call for “Clinical Social Psychiatry.”
This objective will be addressed through three goals with seven steps:
(A) Review social psychiatry’s powerful populational studies on psychiatric epidemiology and Social Determinants of Health & Mental Health (SDH/MH)
1. Adverse Childhood Experiences (ACE) Studies
2. Global Mental Health (GMH) – Treatment Gaps
3. Epidemiology to reflect the burden of disease
(B) Promote translational research of social psychiatric studies – redefining health in social terms
4a. Translational research to redefine health
4b. Mental health in a social context (C) Provide ground-level prescriptions aimed at prevention, promotion, intervention, and adaptation
5. Mental health services to be delivered where people live
6. Shared care/integrated care/collaborative care
7. We can’t do everything – address common and pressing problems
Keywords: Populational studies, social determinants of health & mental health (SDH/MH), translational research, ground-level prescriptions
Borders, Belonging, and Betrayals: A Poetic Conversation Among a Palestinian ...Université de Montréal
Borders, Belonging, and Betrayals: A Poetic Conversation Among a Palestinian Israeli Psychologist, an Italian Canadian Psychiatrist, and a Canadian United Church Pastor in a Time of War
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Beyond shared care in Child and Adolescent Psychiatry: Collaborative care and community consultations
1. Volume 4 • Issue 2 • May-August 2022
WorldSocial
Psychiatry
Ofcial Journal of the World Association of Social Psychiatry
https://waspsocialpsychiatry.org/
www.worldsocpsychiatry.org
World
Social
Psychiatry
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Volume
4
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Issue
2
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May-August
2022
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Pages
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SPECIAL THEME ISSUE
Child Mental Health and Social Psychiatry
Spine 2.5 mm
Theme Issue Editor: Andres J. Pumariega
Theme Issue Co-Editors:
Eugenio Rothe, Rama Rao Gogineni
3. Di Nicola: Beyond shared care in child and adolescent psychiatry
World Social Psychiatry | Volume 4 | Issue 2 | May-August 2022 79
step for an innovative movement in the evolution of a
spectrum of services – from shared care and collaborative
care to a broader range of collaborative partnerships and
practices, including community consultations through the
comparatively new role of “Medical Specialists Responding
in Child and Adolescent Psychiatry” (MSRCAP) for
community mental health teams in Quebec. The goal is
for better coordination and where possible integration of
primary care with behavioral and mental health services.[9]
Ideally, this should start early with the teaching of CAP to
family medicine[10]
and pediatrics trainees.
Kates,[6]
a Canadian leader in shared care, set out the
parameters of this approach:
• “Collaborative mental health care refers to a family
physician or other primary care provider working
together with a psychiatrist or other mental health
worker in a mutually supportive partnership”
• “The responsibilities of care are shared and apportioned
according to the respective skills of the providers and
the (changing) treatment needs of the patient”
The key premises for this approach include these salient
observations:[6]
• The family doctor or other first‑line practitioners play a
key role in mental health care
• 25% of individuals seen in general practice have an
identifiable psychiatric problem (which is nonetheless
not always identified)
• This mental health problem is often anxiety or
depression
• The majority of cases are treated by first‑line
practitioners and are not referred to mental health
services.
Complicating matters, the interface between primary care
providers and specialized mental health care at all ages,
including children and youth, “is characterized by bad
communication, a lack of mutual comprehension, and
limited collaboration.”[6]
Primary care practitioners feel
overburdened by clinical demands, do not always feel
sufficiently trained or supported, and complain about
waiting lists and limited specialized services.
Given the sometimes critical shortage of mental health
resources, collaborative partnerships among second‑line
CAP, first‑line children’s community mental health
services, and primary medical care have become a pressing
priority. In this approach, CAPs function as consultants
aiding primary care physicians (including pediatricians and
family practitioners) to enlarge the range and severity of
problems that they can manage. Key factors include rapid
and easy access to children’s mental health services as
they need arises.[6,11,12]
The Canadian Collaborative Mental
Health Care association[3]
is very active with an annual
conference[13]
and offers a Child and Youth Mental Health
Toolkit[14]
and Child and Youth Mental Health General
Screening Questionnaires.[15]
In a study of one specific interface, pediatrician–
child psychiatrist partnerships improve access to
mental health‑care services with a combination of
indirect (physician to physician discussions), direct (patient
consultations), and follow‑through care of patients for
more severe cases.[16]
This reinforces our approach in CAP
deploying the “the multiplier effect.”[5]
The USA has also made significant advances in this area,
notably in the partnership between Pediatrics and CAP.[17]
The formation of the National Network of Child Psychiatry
Access Programs[18]
in 2011 and the Massachusetts Child
Psychiatry Access Project[19]
along with the Washington
State model[20]
with their Integrated Care Training Program
at the University of Washington[21]
are proven and effective
models of collaboration in children’s mental health care.
The Global Burden of Care: Child
Psychiatric Epidemiology
To put the needs of children’s mental health care in context,
we need to understand the global burden of care that they
represent by studying nonclinical community samples.
North American and worldwide comparisons in child
psychiatric epidemiology are based on populational surveys
of 6–14‑year‑old children, documenting retrospective
6‑month community prevalence rates of children’s mental
disorders. The Isle of Wight surveys undertaken in Britain
in the mid‑1960s created the conceptual apparatus and
methodology for these studies whose principal investigator
offered a 25‑year review of the advances in children’s
psychiatric epidemiology.[22]
The worldwide average of
these studies demonstrates that about 20% of children are
affected by mental health problems, broadly defined (not
necessarily DSM/ICD psychiatric diagnoses). Prevalence
rates vary between 17.6% and 22% of child psychiatric
disorders in nonclinical community samples of children
and adolescents.[23]
Pioneering child psychiatric epidemiological studies have
been conducted in Canada’s two largest provinces.
The Ontario Child Health Study (OCHS) conducted
at McMaster University in the 1980s established that
18.5% of children 6–14 years in Ontario were affected
with a definable mental health problem in the preceding
6 months.[23,24]
Follow‑up studies revealed important
changes in the profiles of children’s mental problems
in Ontario. In the two decades between 1983 and 2014,
studies revealed:[24]
• Dramatic jump of boys 4–11 with attention‑deficit
hyperactivity disorder (ADHD)
• Teens saw a steep increase in anxiety and depression in
boys and girls
• Substantial drop in the prevalence of conduct disorder
among boys
• Among immigrants: 50% drop in prevalence of
children’s disorders
4. Di Nicola: Beyond shared care in child and adolescent psychiatry
80 World Social Psychiatry | Volume 4 | Issue 2 | May-August 2022
• Strong evidence that poverty increases the risk for
childhood disorder in combination with contextual
factors such as neighborhood antisocial behavior
• Geographic shift in prevalence from large urban areas
to small‑medium urban and rural areas.
Finally, in a component study of access to children’s mental
health services in Ontario, the proportion of the children’s
population served increased, but most remained without
contact with mental health services.[24]
The Quebec Child Mental Health Survey (QCMHS),
conducted a decade later by the child epidemiological
research team at the University of Montreal, adapted the
research methodology.[25]
Previous studies focused more
on socioeconomic and sociodemographic characteristics
than on family characteristics. The Quebec investigators
noted that there were no accepted methods to analyze and
interpret the correlates of community studies so the goals
of the study were:[25]
• To identify correlates of DSM‑III‑R internalizing and
externalizing disorders according to informant (youth,
parent, and teacher), for three age groups (6–8, 9–11, and
12–14 years), including relevant family characteristics
• To interpret the relative importance of risk indicators by
ranking correlates according to strength and consistency
of association across age groups
The QCMHS results revealed:[25]
• The overall Quebec population shows 15% prevalence
of mental health problems in children aged 6–14 years
• This contrasts with an alarming rate of 60% in the
substudy of a disadvantaged neighborhood (Hochelaga–
Maisonneuve)
• Inconsistency of correlates across informants
• Individual and family characteristics make a more
important contribution than do socioeconomic
characteristics.
In conclusion, the QCMHS demonstrates the relevance of
“proximal variables” (or more psychological factors such
as family characteristics) in the development of children’s
psychopathology, also found in the OCHS.[26]
The substudy
of a disadvantaged neighborhood in Montreal offers a
complex portrait of the negative impacts of Adverse
Childhood Events (ACE)[27,28]
and the Social Determinants
of Health and Mental Health (SDH/MH)[1,29]
with an
alarming four‑fold increase of problems (60%) over the
provincial average (15%).
In light of the larger findings of the QCMHS that
demonstrated the important contribution of individual and
family aspects, we undertook a more detailed analysis
of single‑parent families in the substudy population, to
test the hypothesis that single‑parenthood increased the
risks for children’s mental health. Our substudy analysis
of single‑parent families offers a complex portrait of the
negative impacts of ACE and SDH/MH, revealing that:
• SDH/MH are multifactorial and multigenerational
• Affecting both more intimate family attachments and
broader social belonging
• Echoing the results of the OCHS.[26]
Informed by ACE, SDH/MH, and QCMHS studies, all
children’s services must address more complex and subtle
social determinants affecting children’s lives and reach
behind the populational parameters to engage the “narrative
resources” that developmental psychologist Jerome Bruner
identified.[30]
Narrative resources are rich and nourishing
when present, yet lead to the impoverishment of affective
and social capacities throughout the lifecycle when absent.
Mental health treatment gaps
The WHO Commission on Social Determinants of
Health (CSDH) study[1,31]
and the associated literature on
GMH reveals significant mental health treatment gaps,
that is the gap between known mental health problems
in the population and access to care.[2]
The WHO has
made concrete and specific recommendations to reduce
the treatment gaps.[31]
The spectrum of services under the
rubric of Shared Care and Collaborative Practices can
alleviate the treatment gap by multiplying the impact of
scarce resources. Related transdisciplinary practices may
also be very helpful especially in low‑ and middle‑income
countries (LMICs). In Brazil, for example, the integrative
community therapy model is a low‑cost, low‑tech
community approach that reaches hundreds, even thousands
of people with mental health problems using comparatively
few professional resources.[32]
Hôpital Maisonneuve‑Rosemont Pilot Study
of Shared Care in Child and Adolescent
Psychiatry: Outline and Satisfaction Survey
At the Child Psychiatry Service of the Hôpital
Maisonneuve‑Rosemont affiliated with the University of
Montreal, we developed a pilot study in 2006 to expand
outpatient child psychiatry consultations in pediatrics to
an extended network of community‑based primary care
pediatricians and family practitioners caring for children
and adolescents. We established clear definitions of our
pilot project that limited the CAP consultation to a key
medical question to be answered in a single session with
rapid access and feedback to the primary care practitioner
in our catchment area in Montreal east within a delay
of 3 days backed up by telephone follow‑up as needed.
A social worker acted as intake and liaison worker.
In the first phase, a needs assessment was undertaken
with key stakeholders by questionnaire and focus‑group
follow‑ups with administrators and clinicians. The primary
care physicians (pediatricians and family physicians)
identified their priorities and needs:
• Rapid access to a CAP consultation for diagnosis and
treatment recommendations
5. Di Nicola: Beyond shared care in child and adolescent psychiatry
World Social Psychiatry | Volume 4 | Issue 2 | May-August 2022 81
• Clarify their role as primary care physicians and what
to expect from shared care
• Psychopharmacology expertise
• Better understanding of “complex cases” – chronicity,
comorbidity, and severity
• Identify difficult to serve and refractory cases and
recommend other interventions.
We then created an intake form and process to ensure
rapid access to the CAP shared care service. Time
slots were reserved specifically for CAP shared care
consultations which are also teaching clinics for medical
students and residents in psychiatry. An extensive
campaign was undertaken to promote the new service
which rapidly grew in popularity. The social worker
who acted as liaison with primary care physicians
ensured ongoing updates and refinements of the process
and together we conducted a survey about the level of
satisfaction with the CAP shared care service.[33]
The
pilot study identified the consultation requests received in
a 3‑month period (36 cases of 48 seen), examining such
parameters as age, diagnosis, and orientation after the
consultation [Tables 1‑3].
The recommendations that flowed from this pilot study
included:
• Focusing on ADHD, the most common reason for
referrals
• Referral mechanisms were clarified and simplified with
a structured intake form
• Clarification of the roles of the teams in CAP, pediatrics,
and family medicine for follow‑through care
• Continual evaluation of the intake form and process
• Consider expanding the shared care consultation to
primary care physicians in the community
We did follow‑through studies each year for the next
5 years, which showed a steady increase in service
utilization and a high level of satisfaction of both the
referring physicians (100% on most parameters, including
rapid access and response; 92% for diagnosis; and
somewhat lower for recommendations at 71%) as well
as the young patients and their families (over 90%).
The CAP shared care service was then expanded to all
the primary care physicians in the entire catchment area
of more than 100,000 youth (up to 18 years of age) in
Montreal east.
Beyond Shared Care: Innovations in Health
Care
In related innovations in health care, we have employed the
notion of the “patient partner” in the Faculty of Medicine
at the University of Montreal.[34]
In this approach, patients
and their significant others become partners in their own
care. This includes partners, spouses, and family members
for patients of all ages. This extended network can become
an integral part of the treatment team.[35]
The next step in this approach is the “peer helper” or pair
aidant in French. The “peer help mediator” becomes a
bridge between patients, their families, and the health and
social care services. Their presence as mediators improves
the patient–therapist relationship and enhances the patient’s
recovery.[36]
The Province of Quebec has recognized the practice of
MSRCAP for community mental health teams for the last
dozen years. I have been doing it for 35 years as a community
child psychiatrist for which I recently won recognition
from the Canadian Academy of Child and Adolescent
Psychiatry (CACAP) with the Naomi Rae‑Grant Award (2021)
for community child psychiatry. This extends the role of
consultant from individual providers to entire community
mental health teams, offering direct and indirect consultations,
peer supervision, and knowledge transfer and team building.
Table 1: Reason for the shared care consultation
Identified problem ‑ DSM‑IV n (%)
ADHD 14 (38.8)
No comorbidity 6
With comorbidity 8
Tourette syndrome 1 (2.7)
Obsessive‑compulsive disorder 1 (2.7)
Language disorder 2 (5.5)
Pervasive developmental disorder 2 (5.5)
Depression 3 (8.3)
Anxiety/separation anxiety 6 (16.7)
Behavioural problem 7 (19.4)
Total 36 (100)
DSM‑IV: Diagnostic and statistical manual of mental disorders,
fourth edition, ADHD: Attention‑deficit hyperactivity disorder
Table 2: Shared care consultations by age group
Age group n (%)
0-5 4 (11.1)
6-8 15 (41.6)
9-10 7 (19.4)
11-12 6 (16.6)
13-16 4 (11.1)
17+ 0
Total 36 (100)
Table 3: Orientation of cases after the shared care
consultation
Orientation n (%)
Shared care (return to referring MD) 6 (16.6)
First‑line mental health team 22 (61.1)
First‑line psychosocial team 4 (11.1)
Other 4 (11.1)
Specialized clinics ‑ Second‑line CAP 2
CAS and other social services 2
Total 36 (100)
CAP: Child Adolescent Psychiatry, CPS: Child Protective Services,
MD: Referring physician
6. Di Nicola: Beyond shared care in child and adolescent psychiatry
82 World Social Psychiatry | Volume 4 | Issue 2 | May-August 2022
Continuum of collaborative care
We can place these innovations on a “spectrum of care”
or a “continuum of collaborative practices.” We start with
the traditional medical terms of first‑line care (generalist
or family physician and first‑line psychosocial services)
and second‑line care (specialty and subspecialty medical
services), then we can add Shared Care Consultations and
MSRCAP in between them to create bridges, enhancing
communication among health‑care providers and improving
access to care in children’s mental health. Doherty[11]
calls
for a “continuum of collaboration” based on the level of
physical integration of services [Figure 1].
In this conceptual model, the organization of service
providers range from the traditional (separate but equal
partners), to coordinated care (consultations and greater
communication), to colocation with either partner visiting
the other (as in a CAP doing onsite visits to a pediatric
clinic or a pediatrician working at a CAP clinic), and
finally, integrated care where both health‑care services
work together in a collaborative way in the same physical
environment.[11]
Another way to organize services uses
the Four Quadrant Clinical Integration Model[9]
in
which services are organized according to greater risk in
physical versus behavioral or psychiatric health risk and
status [Figure 2].
Conclusions
There are not enough psychiatric specialists and
subspecialists in any country, even in an advantaged and
progressive country with national health care like Canada,
but the issues of access to mental health care in both
general and child psychiatry are especially acute in LMICs
and the Global South,[37,38]
prompting the Royal College
of Psychiatrists (UK) to publish manuals to guide primary
care practitioners[4,39]
in those health‑care systems.
We must employ ways to “multiply” our impact through
indirect consultations to other physicians, mental health
professionals, and responding to community health and
social care teams to reach more of the population. This
increases not only our reach but our effectiveness and level
of mutual satisfaction.[5,40]
The ultimate goal is a better
integration of psychiatry and child psychiatry with primary
medical care.[9,41]
This is a GMH issue[42]
whose slogan, “No health without
mental health,”[43]
is acutely felt in children’s mental health
at all levels, from the study of mental health gaps[1,2,37]
to
the provision of care and mentoring trainees for the next
generation in the delivery of ever‑more responsive clinical
models of children’s mental health care.[5,10,44]
It reflects
the clinical salience of the SDH/MH,[1,29]
along with the
powerful populational data of the ACE study.[28,29]
While this is relevant and helpful in Canada, it is crucial
for the LMICs of the Global South.[37,38]
Furthermore,
collaborative care practices must be promoted as low‑tech
practical clinical tools for the social psychiatrist and a key
plank in the platform of 21st
century social psychiatry.[45]
Acknowledgments
The author gratefully acknowledges the valuable
collaboration of Francyne Brosseau, MSW, in the pilot
project and study of Shared Care in Family Medicine and
Paediatrics with the research support of the Department of
Psychiatry, Hôpital Maisonneuve‑Rosement. The author
conducted an analysis of the substudy of the QCMHS
focusing on single‑parent families in a disadvantaged
neighborhood of Montreal with Lise Bergeron, PhD, and
her associates at the Hôpital Rivières‑des‑Prairies, affiliated
with the Faculty of Medicine, University of Montreal. In
2021, the author was given the Naomi Rae‑Grant Award
by the CACAP in recognition of his work in collaborative
community child psychiatry
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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