Child and adolescent mental health and counselling in Mugello, Italy |
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| Authors: | Massimo Papini Roberto Leonetti Maurizio Timpanelli Luca Mercatali Gavino Maciocco |
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| Institution: | (1) Child Neuropsychiatry Unit, Department of Neurological and Psychiatric Sciences, University of Florence, Italy;(2) Department of Community Medicine, Province of Florence, Italy |
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| Abstract: | This report deals with a program to train the General Practitionners and Pediatricians (P&;P) in child and adolescent mental health (CAMH) counselling, undertaken by the Community Service child neuropsychiatrists (CNs) in the Mugello, a mountain region near Florence (Italy) of approx. 500 square miles, with about 58,000 residents of which 9,000 under eighteen years of age. The program began in 1996 and, after an organizational phase, the P&;P's professional interests and needs dealing with CAMH were tested (review phase). The remarkable P&;P's interest and motivations in CAMH were confirmed by the significant percentage (about 50%) of voluntary attendance and the high percentage (about 91%) of active participation in the meetings and by the 50% increment of first referrals to specialists during a test-period lasting two month (February--March 1997/96). A close-ended questionnaire investigated the most frequent CAMH problems faced by the P&;P, which prevalently turned out to be ordinary events. The high rate (about 54%) of missing responses to questions about the P&;P's possibility to aknowledge their own sources of knowledge on such problems and the high positive response rate (about 70%) indicating a non professional source of knowledge reveal the P&;P's awareness of professional insecurity in CAMH, and this was the cause of their difficulties in distinguishing between ordinary events and psychopathology. The P&;P replied positively in 93% of the cases to the question “do you think it is useful for your professional self-confidence to examine these problem areas in depth?” The method that they preferred proved to be “continuing training courses” (35%). These results provided the basis for the implementation phase with a continuing professional training program. The P&;P's awareness of professional insecurity and the admission of their need for training and information in CAMH motivate their requests for CNs Counselling reference in order to deal with psychiatric cases, while the P&;P's humane approach with patients, revealed during the meetings and in the questionnaire, simplifies the task of training the P&;P to become counsellors in CAMH problems which are less severe. |
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