Introduction CHILD AND ADOLESCENT PSYCHIATRY SERVICES

39 Psychiatric And Mental Health Services Operational Policy 6.3.3.2 Inpatient Services Some patients may require admission to the wards for more intensive treatment. In the absence of dedicated Child and Adolescent wards, care must be taken to prevent complications arising from admitting child and adolescent patients into adult psychiatry wards. In general, admission of children aged less than 12 years into adult wards should be avoided as far as possible to prevent trauma and complications to the child. Arrangements should be made with Pediatrics to admit child patients into Pediatric wards, if possible. Common reasons for inpatient treatment: • severe depression • serious suicidal risk • severe psychotic states • severe anorexia nervosa Decisions to admit should be made at specialist or consultant level. Nursing staff should be trained to manage the needs of child and adolescent inpatients. Regular ward rounds are required to be done daily by psychiatrists and medical oficers where review of management and appropriate changes are made. Length of inpatient management should be tailored to the speciic needs of each patient. 6.3.3.3 Ward Referrals Consultation-Liaison General psychiatrists and child and adolescent psychiatrists should respond promptly to referrals of children and adolescents from other wards. Depending on the urgency, patients should be seen within 24 hours of referral or even immediately as the case may be. It is essential that a thorough examination be made and indings or recommendations conveyed to the patients, parents and referring doctors as soon as possible. Treatment should be instituted without delay. Psychiatrists should coordinate the services of allied 40 Psychiatric And Mental Health Services Operational Policy professionals who may also be needed in the management of a particular patient. 6.3.3.4 Suspected Child Abuse And Neglect SCAN SCAN patients require prioritization as there may be serious psychiatric emotional sequelae of the different types of abuse. Generally, psychiatrists general or child and adolescent work as a member of the SCAN team managing victims of abuse. The roles include obtaining information that is unobtainable by other team members using the usual techniques and managing the psychological emotional trauma associated with abuse. In all work with SCAN patients, safety, protection and well-being of the child adolescent are the most important considerations. Psychiatrists should document indings with care and in detail as SCAN cases are medico legal in nature and we may be required to go to court as witnesses when the cases go to trial. 6.3.3.5 Hospital-Based Community Psychiatry Services Children and adolescents will also beneit from community psychiatry services, especially those who have severe psychiatric disorders and who have high risk factors refer to section on Hospital-based Community Psychiatry. Existing community psychiatry teams should be given training in the management of common psychiatric conditions of children and adolescents so that they may extend their services to this group. In hospitals where such teams are not available, the nearest available teams may be able to provide the service. 6.3.3.6 Collaboration With Primary Care Clinics, Schools, Welfare Department And NGO’s Collaboration with other professionals and agencies is an essential component of the work that psychiatrists do for children and adolescents. Such collaborative efforts also provide psychiatrists