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Psichiatria dell’infanzia e dell’adolescenza (2011), vol. 78: 314-327
Inserimenti residenziali e semiresidenziali da parte di un servizio territoriale di salute mentale e riabilitazione infanzia-adolescenza Residential and daycare referrals from a community-based child and adolescent mental health and rehabilitation service Sofia Panarello*, Stefano Palazzi*, Elena Bruni*, Dina Benetti*, Manuela Colombari*, Franca Emanuelli*, Patrizia Folegani*, Elisabetta Manfredini*, Isabella Merlin*, Gloria Soavi*, Ernesto Stoppa*, Dora Suglia*, Lorenza Zeriola*, Elisabetta Zucchini*
Summary Patients admitted to residential and day care often remain under the clinical and financial responsibility of the referring community services. In 2009, Ferrara virtual outpatient unit included 17 males and 3 females in 14 different centres. Checklist data were collected from socio-demographic information (family, origin, class, urbanization, sex – acronym Focus) and clinical records (diagnostic formulation, ICD-10, C-GAS, admission’s circumstances, drug history, ongoing course, educational-therapeutic plan, admission duration, additional assistance, current symtoms, complications and discharge arrangements). Administrative data were also noted, such as the distinction in social vs health-funded service users, the age and diagnostic mix of the admitting centre, total and emergency beds or placements available, the provision of medical or nurse assistance, accreditation vs autorization status, and distance from users’ homes. Finally, for each patient, clinical outcome and care appropriateness were measured through two 6-value Likert ordinal scales. Results show that the residential and day-care centres offer reflects social care and child protection needs. However, most patients also present health needs. When a mental health symptom or behaviour appears, either due to a pre-existent autism or a new anxious-depressive episode, the residential and day-care centres call each patient’s community service tens or hundreds kilometers away. That may possibly explain why our community child psychiatrists have rated the centres’ overall care as better in efficiency than in clinical appropriateness. Key words CAMHS (Child and Adolescent Mental Health Service) – Residential care – Daycare – Appropriateness – Service quality.
* Smria/Uonpia Ausl & Università di Ferrara, Dipartimento Assistenziale Integrato Salute Mentale e Dipendenze Patologiche (Ospedale San Giorgio), Ferrara.