Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.
Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy.
J Child Psychol Psychiatry. 2021 Sep;62(9):1067-1069. doi: 10.1111/jcpp.13371. Epub 2020 Dec 24.
While COVID-19 pandemic has allegedly passed its first peak in most western countries, health systems are progressively adapting to the 'new normality'. In child and adolescent mental health services (CAMHS), such organizational envisioning is needed to cope with the foreseeable psychological effects of prolonged social isolation induced by nation-wide public health measures such as school closure. CAMHS need to ensure flexible responses to the psychopathological consequences of evolving societal dynamics, as dramatically actualized by the unexpected COVID-19 pandemic. This would imply (a) shifting the focus of intervention from symptom reduction and containment of acute crises in a comparatively small number of severe cases to a broader preventive strategy, guided by a gradient of increasing intensity and specificity of treatment; (b) promoting smooth access pathways into services and encouraging participation of families; (c) adopting a transdiagnostic staging model to capture the developmental fluctuations from subsyndromal to syndromal states and back, with related changes in the intensity of the need of care; and (d) implementing digital tools to encourage help-seeking and compliance by digitally native youth.
虽然 COVID-19 大流行据称已经在大多数西方国家度过了第一个高峰期,但卫生系统正在逐步适应“新常态”。在儿童和青少年心理健康服务(CAMHS)中,需要进行这种组织设想,以应对全国范围内的公共卫生措施(如学校关闭)所导致的可预见的心理影响。CAMHS 需要灵活应对不断变化的社会动态的心理病理后果,正如 COVID-19 大流行所戏剧性地实际表现的那样。这将意味着:(a)将干预的重点从减少症状和控制少数严重病例的急性危机转移到更广泛的预防策略,该策略由治疗的强度和特异性逐渐增加的梯度指导;(b)促进服务的顺利进入途径,并鼓励家庭参与;(c)采用跨诊断分期模型来捕捉从亚综合征到综合征状态的发展波动,以及相关的护理需求强度变化;(d)实施数字工具,鼓励数字原生青年寻求帮助和遵守规定。