Overview of Regional Care for Adolescents Over the Age of 15 With a Mental State at Risk in France

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2025-03-17 DOI:10.1111/eip.70028

Célia Longuet, Louis Tandonnet, Laurent Lecardeur

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Abstract

Introduction

Early detection and intervention in psychotic disorders are public health issues that have led to the creation of specific care systems in France, the visibility of which is still debated. Moreover, these services are often concentrated in adult rather than child psychiatry, which may increase the duration of untreated psychosis.

Objectives

The main objective of this study was to take stock of the care provided in the adolescent unit of the Candélie hospital (Lot-et-Garonne, France) in 2023 and the proportion of adolescents aged over 15 diagnosed with a mental health risk who were followed up. The second objective was to propose an experimental approach to improving care for this group of patients by introducing an ‘advanced practice nurse’.

Methods

Activity data for 2022 were collected by the IT department of the Candélie hospital. At risk mental state adolescents were identified according to the COGDIS and COPER criteria.

Results

The results of the retrospective study carried out in 2022 show that staffing levels and care units in adolescent medicine are saturated. Depending on the system, between 19% and 39% of the patients are considered to have an at risk mental state. The construction of an Ishikawa diagram highlights three major issues on which the advanced nurse practitioner could intervene: support the system under pressure, delegate part of the medical activities given the shortage of doctors, and coordinate the transition of child and adolescent mental health care to adult mental health care.

Conclusion

Restructuring existing health care systems by including initial consultation and monitoring of adolescents and their families by advanced practice nurses would allow earlier intervention with these adolescents.

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法国15岁以上精神状态有危险的青少年区域护理概述

精神疾病的早期检测和干预是公共卫生问题，导致法国建立了专门的护理系统，其可见度仍存在争议。此外，这些服务往往集中在成人精神病学而不是儿童精神病学，这可能会增加未治疗精神病的持续时间。本研究的主要目的是评估2023年在candemlie医院（Lot-et-Garonne，法国）青少年病房提供的护理，以及随访的15岁以上被诊断有精神健康风险的青少年的比例。第二个目标是提出一种实验方法，通过引入“高级执业护士”来改善对这组患者的护理。方法收集2022年康德和康德和医院IT科的活动数据。根据COGDIS和COPER标准确定有危险精神状态的青少年。结果2022年进行的回顾性研究结果表明，青少年医学的人员配备水平和护理单位已经饱和。根据系统的不同，19%到39%的患者被认为有危险的精神状态。石川图的构建突出了高级执业护士可以干预的三个主要问题：在压力下支持系统，在医生短缺的情况下委派部分医疗活动，协调儿童和青少年心理卫生保健向成人心理卫生保健的过渡。结论通过高级执业护士对青少年及其家庭的初步咨询和监测来重组现有的卫生保健系统，可以对这些青少年进行早期干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.