MEDICAL CARE FLOW CHART Caregiver CHILDREN AND Family members ADOLESCENTS Children ´ s Court PSYCHIATRIC AND MEDICAL PRE-SELECTION SOCIAL WORKER AND FAMILY THERAPIST: Contact with family or guardian; Making the 1 st appointment 1 st APPOINTMENT: Psychiatric and pediatric evaluation DIAGNOSTIC ART THERAPY request of subsidiary exams EVALUATION PROCESS sociodemographic data EDUCATIONAL NEUROPSYCHOLOGICAL PSYCHOLOGIST: ASSESSMENT Contact with PHYSICAL schools EVALUATION SPEECH THERAPY FAMILY EVALUATION: EVALUATION OCCUPATIONAL Interviews with family or THERAPY guardian EVALUATION OUTLINE THERAPEUTIC PLAN - CASE MANAGER
MEDICAL CARE FLOW CHART OUTLINE AND EVALUATION OF THERAPEUTIC PLAN (weekly meetings) PSYCHIATRIC PHYSICAL APPOINTMENTS ORIENTATION INDIVIDUAL WORKSHOPS EDUCATIONAL OT PSYCHOTHERAPY (Sexuality, ORIENTATION and Newspaper, SCHOOL SUPPORT Radio, Texts) GROUP INDIVIDUALIZED PSYCHOTHERAPY FAMILY FAMILY GROUP PSYCHOTERAPY ORIENTATION ART THERAPY - Data co collec ectio tion n and tabulati bulation - Sci cien entific tific produ duction ction and publicat blication on - TREATM ATMENT ENT METHOD HODOLOG OLOGY Y SPECIFI IFIC FOR THIS S POPUL ULATI TION ON
65% male 84,6% from shelters N= 544 54% upbringing in shelters 100% maltreatment and neglect 75% physical and/or sexual abuse
TOTAL DE ATENDIMENTOS – 74.549 MÉDIA MENSAL – 1.021 Set/07 a Set/13 2000 1707 1550 2007 2008 2009 2010 2011 2012 1390 1363 1326 1344 Set a Dez 1500 1057 9841 15372 13117 12133 10558 2049 atendimentos atendimentos atendimentos atendimentos atendimentos atendimentos 924 1000 2013 818 Jan a Set 11479 512 820 1281 1093 1011 880 500 atendimentos média média média média média média 1275 atendimentos atendimentos atendimentos atendimentos atendimentos atendimentos média atendimentos 0 JAN FEV MAR ABR MAI JUN JUL AGO SET
“CHILDREN AND ADOLESCENTS LIVING IN THE STREETS OF DOWNTOWN SÃO PAULO: mental health status and the effectiveness of multidisciplinary intervention in the process of social and family reintegration ”
METHODOLOGY Evaluate all children/adolescents: - Questionnaire on SOCIODEMOGRAPHIC DATA - Clinical Interview and K-SADS - Children Global Assessment Scale (C-GAS) - Clinical Global Impression (CGI) - Strengths and Difficulties Questionnaire (SDQ) SIX-MONTH FOLLOW-UP Children/Adolescents: - C-GAS - CGI
AFTER 2 YEARS... Prevalence of psychiatric disorders Initial and final SDQ scores, C-GAS, CGI Attendance to Equilibrium activities Treatment dropout rate RATE OF FAMILY REINTEGRATION!!! Factor ctors relat lated ed to o po positive itive and nd ne negat ative ive ou outcomes comes
• Any psychiatric disorder: 88.8% • Substance use disorders: 40.4% • Mood disorders: 35.3% • Hyperkinetic disorders: 16.2% • Anxiety disorders: 8.8%
88.89% at least one psychiatric diagnosis
74,549 appointments from sep/07 to sep/13 Around 1,021 appointments monthly Total of 544 children and adolescentes assisted (around 99 families attended monthly) 43% (n=234) dropped out 50.37% (n=274) on treatment or completed treatment plan 6.25% (n=34) where discharged because they moved to other cities with their families 1 death 43.8% (n=238) were reintegrated into families (original or step families)
• General Coordinator • 2 executive coordinators • Medical Care Coordinating Psychiatrist • 3 Psychiatrists • 1 Pediatrician • 3 Psychologist for family treatment • 4 Psychologist specialized in children and adolescents • 2 Neuropsychologists • 2 Occupational Therapists • Art Therapist • 2 Speech Therapist • Physical Therapist • 2 Educational Psychologists • Psychiatric Nursing Staff • 2 Social Workers • Research Coordinator • Computer science tecnitian • Local Maneger • Trainee
Department and Institute of Psychiatry from Hospital das Clínicas Medicine School from São Paulo University , Brazil e-mail: sscivoletto@uol.com.br
Recommend
More recommend
