Telepsychiatry consultation for primary care treatment of children and adolescents receiving child protective services in Chile: mixed methods feasibility study
Author
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Mundt, Adrián
Author
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Irarrázaval Domínguez, Matías
Author
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Martínez, Pablo
Author
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Fernández González, Olga
Author
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Martínez Nahuel, Vania Angélica
Author
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Rojas Castillo, María Graciela
Admission date
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2022-03-22T12:49:32Z
Available date
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2022-03-22T12:49:32Z
Publication date
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2021
Cita de ítem
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JMIR Public Health and Surveillance Volume 7 Issue 7 Article Number e25836 Jul 2021
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Identifier
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10.2196/25836
Identifier
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https://repositorio.uchile.cl/handle/2250/184312
Abstract
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Background: Children and adolescents living under the supervision of child protective services have complex mental health care needs. The scarcity and uneven distribution of specialized mental health teams in Chile may limit the provision and quality of care for this vulnerable population. Telepsychiatry can address such health inequities. Objective: The objective of this study was to evaluate the feasibility of a telepsychiatry consultation program for primary health care (PHC) treatment of children and adolescents living under the supervision of child protective services. Methods: We developed a telepsychiatry consultation program for two rural PHC clinics located in central Chile (Valparaiso Region) and evaluated its implementation using a mixed methods study design. The program consisted of videoconferencing mental health consultation sessions scheduled twice per month (each 90 minutes long), over a 6-month period, delivered by child and adolescent psychiatrists based in Santiago, Chile. We described the number of mental health consultation sessions, participant characteristics, perceived usefulness and acceptability, and experiences with the telepsychiatry consultation program. Results: During the 6-month study period, 15 videoconferencing mental health consultation sessions were held. The telepsychiatry consultation program assisted PHC clinicians in assigning the most adequate diagnoses and making treatment decisions on pharmacotherapy and/or psychotherapy of 11 minors with complex care needs. The intervention was perceived to be useful by PHC clinicians for improving the resolution capacity in the treatments of this patient population. Limitations such as connectivity Conclusions: The telepsychiatry consultation program was feasible and potentially useful to support PHC clinicians in the management of institutionalized children and adolescents with complex psychosocial care needs living in a poorly resourced setting. A larger scale trial should assess clinical outcomes in the patient population. Regulations and resources for this service model are needed to facilitate sustainability and large-scale implementation.
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Patrocinador
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Funds for developing a telemedicine project at the Hospital Clinico Universidad de Chile
Agencia Nacional de Investigacion y Desarrollo (ANID) Millennium Science Initiative/Millennium Institute for Research on Depression and Personality-MIDAP ICS13_005
ANID - Millennium Science Initiative Program NCS17_035
FONDECYT, ANID 1190613
e-mental health network of the Universidad de Chile VID U-REDES-C_2018_07
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Lenguage
dc.language.iso
en
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Publisher
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JMIR
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Type of license
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Attribution-NonCommercial-NoDerivs 3.0 United States
Telepsychiatry consultation for primary care treatment of children and adolescents receiving child protective services in Chile: mixed methods feasibility study