Children s Court PSYCHIATRIC AND MEDICAL PRE-SELECTION SOCIAL - - PowerPoint PPT Presentation

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Children s Court PSYCHIATRIC AND MEDICAL PRE-SELECTION SOCIAL - - PowerPoint PPT Presentation

Nov 04, 2023 104 likes •323 views

MEDICAL CARE FLOW CHART Caregiver CHILDREN AND Family members ADOLESCENTS Children s Court PSYCHIATRIC AND MEDICAL PRE-SELECTION SOCIAL WORKER AND FAMILY THERAPIST: Contact with family or guardian; Making the 1 st appointment 1 st

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PSYCHIATRIC AND MEDICAL PRE-SELECTION MEDICAL CARE FLOW CHART

SOCIAL WORKER AND FAMILY THERAPIST:

Contact with family or guardian; Making the 1st appointment

1st APPOINTMENT: Psychiatric and pediatric evaluation request of subsidiary exams sociodemographic data EDUCATIONAL PSYCHOLOGIST: Contact with schools

DIAGNOSTIC PROCESS

OUTLINE THERAPEUTIC PLAN

  • CASE MANAGER

FAMILY EVALUATION: Interviews with family or guardian

SPEECH THERAPY EVALUATION PHYSICAL EVALUATION

Caregiver Family members Children´s Court

OCCUPATIONAL THERAPY EVALUATION ART THERAPY EVALUATION

CHILDREN AND ADOLESCENTS

NEUROPSYCHOLOGICAL ASSESSMENT

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PSYCHIATRIC APPOINTMENTS GROUP PSYCHOTHERAPY INDIVIDUALIZED FAMILY PSYCHOTERAPY WORKSHOPS (Sexuality, Newspaper, Radio, Texts) PHYSICAL ORIENTATION

  • Data co

collec ectio tion n and tabulati bulation

  • Sci

cien entific tific produ duction ction and publicat blication

  • n
  • TREATM

ATMENT ENT METHOD HODOLOG OLOGY Y SPECIFI IFIC FOR THIS S POPUL ULATI TION ON

MEDICAL CARE FLOW CHART ART THERAPY OT FAMILY GROUP ORIENTATION INDIVIDUAL PSYCHOTHERAPY EDUCATIONAL ORIENTATION and SCHOOL SUPPORT OUTLINE AND EVALUATION OF THERAPEUTIC PLAN (weekly meetings)

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 65% male  84,6% from shelters  54% upbringing in shelters  100% maltreatment and neglect  75% physical and/or sexual abuse

N= 544

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818 924 1390 1707 1550 1363 1057 1326 1344 500 1000 1500 2000

JAN FEV MAR ABR MAI JUN JUL AGO SET

2008 2009 2010 2011 9841

atendimentos

820

média atendimentos

15372

atendimentos

1281

média atendimentos

13117

atendimentos

1093

média atendimentos

12133

atendimentos

1011

média atendimentos

Set/07 a Set/13

2007 2049

atendimentos

512

média atendimentos

Set a Dez

2012 10558

880

média atendimentos

atendimentos

TOTAL DE ATENDIMENTOS – 74.549 MÉDIA MENSAL – 1.021

2013

11479

atendimentos

1275

média atendimentos Jan a Set

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“CHILDREN AND ADOLESCENTS LIVING IN THE STREETS OF DOWNTOWN SÃO PAULO: mental health status

and

the effectiveness of multidisciplinary intervention in the process of social and family reintegration”

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METHODOLOGY

Evaluate all children/adolescents:

  • Questionnaire on SOCIODEMOGRAPHIC DATA
  • Clinical Interview and K-SADS
  • Children Global Assessment Scale (C-GAS)
  • Clinical Global Impression (CGI)
  • Strengths and Difficulties Questionnaire (SDQ)

SIX-MONTH FOLLOW-UP

Children/Adolescents:

  • C-GAS
  • CGI
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AFTER 2 YEARS...

 Prevalence of psychiatric disorders  Initial and final SDQ scores, C-GAS, CGI  Attendance to Equilibrium activities  Treatment dropout rate RATE OF FAMILY REINTEGRATION!!!

Factor ctors relat lated ed to

  • po

positive itive and nd ne negat ative ive ou

  • utcomes

comes

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SLIDE 8
  • Any psychiatric disorder: 88.8%
  • Substance use disorders: 40.4%
  • Mood disorders: 35.3%
  • Hyperkinetic disorders: 16.2%
  • Anxiety disorders: 8.8%
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SLIDE 9

 88.89% at

least one psychiatric diagnosis

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 74,549 appointments from sep/07 to sep/13  Around 1,021 appointments monthly  Total of 544 children and adolescentes assisted

(around 99 families attended monthly)

 43% (n=234) dropped out  50.37% (n=274) on treatment or completed

treatment plan

 6.25% (n=34) where discharged because they

moved to other cities with their families

 1 death

43.8% (n=238) were reintegrated into families

(original or step families)

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  • General Coordinator
  • 2 executive coordinators
  • Medical Care Coordinating Psychiatrist
  • 3 Psychiatrists
  • 1 Pediatrician
  • 3 Psychologist for family treatment
  • 4 Psychologist specialized in children and adolescents
  • 2 Neuropsychologists
  • 2 Occupational Therapists
  • Art Therapist
  • 2 Speech Therapist
  • Physical Therapist
  • 2 Educational Psychologists
  • Psychiatric Nursing Staff
  • 2 Social Workers
  • Research Coordinator
  • Computer science tecnitian
  • Local Maneger
  • Trainee
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SLIDE 20

Department and Institute of Psychiatry from Hospital das Clínicas Medicine School from São Paulo University , Brazil

e-mail: sscivoletto@uol.com.br