More and more young people are compulsorily admitted to psychiatry. They often end up among adults in a closed ward, where they usually do not belong. ‘It is difficult to offer tailor-made care there’, says child psychiatrist Daniel Neves Ramos.
Jan Debaus13 July 2023, 19:22
Where does this increase in compulsory admissions come from?
Neves Ramos: “For me, that increase coincides chronologically with the corona crisis. The numbers of collocations have fluctuated slightly over the past ten years anyway. But you will see a real peak from 2019. In two years time, we saw the number of collocations more than double.
“In addition, the care landscape for the mental health of minors has long been historically behind. Young people who have been on waiting lists for years will eventually become much more persistent and complex in their problems. This creates difficult situations that you no longer get countered on an outpatient basis.”
How exactly has the corona crisis contributed to this increase?
“I think everyone has felt that you came under pressure during the corona period, because your social network disappeared to some extent. I think young people still enjoyed the first quarantine because they didn’t have to go to school. But from the second, third and fourth waves, we saw that the situation had a negative effect on the health of young people. They had to let go of their good contacts with friends and their hobbies, and that turned out to be very drastic.
“It is not for nothing that the action of De Warmste Week this year revolves around the mental well-being of young people during the summer holidays. During the holidays, children no longer suffer from school-related stress, but for young people in vulnerable families, a large social network is also lost. Problems so often stay under the radar. Until they eventually escalate.”
Where do these young people usually end up?
“Each province has a number of child psychiatric closed beds. If you are lucky you will end up there. But those places are very limited. The province of Antwerp has two beds, Flemish Brabant and Limburg each have five.
“When those beds are full, the story ends in child psychiatry and the young people go to the recognized beds for compulsory admission. There are adults with a completely different type of pathology.”
Daniel Neves Ramos: “From the second, third and fourth corona waves, we saw that the situation had a negative effect on the health of young people.”Image ZNA Antwerp
Does contact with adults there do more harm than good to young people?
“In most cases, yes. I can still understand that a seventeen-year-old who gets his first acute psychosis is placed in an adult ward. Because there are still psychotic patients there. But we have also seen that a thirteen-year-old with a school phobia, who threatened suicide if he had to go to school again, was placed in such a department via a collocation. That child came out of there more traumatized than it helped.
“We once took over a 14-year-old from a closed adult ward who had learned to use speed for the first time. A minor was also abused by a manic adult woman there.
“So things really do go wrong in a department like that. That is because it is not a safe and suitable environment for young people. For example, an adult psychiatric hospital, unlike a child psychiatric service, does not have a school. There is only limited space for family therapy. This makes it difficult to offer customized care.”
What illnesses do young people suffer from?
“In general, there are three large groups: children with developmental disabilities such as autism or an intellectual disability; with behavioral and emotional disorders; and children with a history of trauma. Three completely different categories, each of which requires specific care.”
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2023-07-13 17:22:57
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