Child and Adolescent Mental Health outpatient prioritisation policies
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Copyright (c) 2023 Revista de Psiquiatría Infanto-Juvenil
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DOI:
https://doi.org/10.31766/revpsij.v40n4a5Keywords:
waiting lists, quality of health care, ambulatory care information systems, mental health, referral and consultationAbstract
Objective: The increase in care demands, in a context of generalised crisis of resources, makes it necessary to use differential management systems that guarantee equity and quality in outpatient care, similar to the systems for prioritising demands in Emergency Departments. Material and methods: The HEADS-ED (Home, Education, Activities/peers, Drugs/alcohol, Suicidality, Emotions/behavior, Discharge resources) and Western Canada Waiting List (WCWL) scales were used to retrospectively evaluate the demand of several outpatient child and adolescent mental health centres in the Community of Castilla y León (Spain), collecting reasons for response times and the prioritisation systems currently used (normal or preferential). Results: It has been observed that the median waiting time for a normal demand is 60 days (Interquartile range or IQR=40,75-113,25) vs. 35.0 days (IQR=21,0-35,0) for preferential demand, which decreases with the intake interview to 21,0 days (IQR=11,0-29,0) vs. 5,0 days (IQR=1,0-7,0) respectively. Depending on the system used (HEADS-ED or WCWL Finnish or Canadian model) for the cases referred to Child and Adolescent Mental Health the cut-off point is not reached by 13,2%, 40,7% and 76,3%, respectively. Conclusions: Prioritisation systems (HEADS-ED and WCWL) have detected unjustified demands showing that assessment methods of current preferred cases are not useful. It is suggested that there is a need to establish online demand management systems, prioritisation systems and expanded modalities of care to improve care processes in a coordinated manner.
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