THE ROLE OF EMERGENCY PSYCHIATRY SOCIAL WORK IN A VIRTUAL CLINIC DURING THE COVID-19 PANDEMIC

The Psychiatry Emergency Services (PES) virtual clinic is an innovative clinical program that was established to enhance access to psychiatric crisis follow-up care during COVID-19. The clinic provides psychiatric follow-up via scheduled phone calls or videoconference for patients that have been seen by the PES team. The social worker has an important role on the PES virtual clinic team: they initiate initial assessments, collaboratively develop follow-up plans, and facilitate community care. The clinic meets the provincial agenda to reduce Emergency Department (ED) visits, ED/PES wait times, ED/PES overcrowding, and inappropriate admissions, while addressing both psychiatric needs and social determinants of health in an acute care setting. Throughout our survey of relevant literature, we found little research to inform the implementation of virtual care in Canadian healthcare emergency services (Hensel et al., 2020;Serhal et al., 2017). More specifically, there is a void in research regarding a collaborative psychiatric and social work care model in the context of a global pandemic. Further robust studies are needed and encouraged that use emergency psychiatric settings as critical prevention sites of mental health crises.Alternate :La clinique virtuelle des Psychiatry Emergency Services (PES) est un programme clinique innovant qui a été mis en place pour améliorer l’accès aux suivis lors des crises psychiatriques pendant la pandémie de la COVID-19. La clinique assure un suivi psychiatrique par le biais d’appels téléphoniques ou de vidéoconférences pour les patients qui ont été vus par l’équipe des PES. La travailleuse sociale joue un rôle important au sein de l’équipe de la clinique virtuelle du PES : elle initie les évaluations initiales, élabore en collaboration des plans de suivi et facilite les soins de proximité. La clinique répond au plan provincial visant à réduire les visites aux services d’urgence, les temps d’attente aux services d’urgence/PES, l’engorgement des services d’urgence/PES et les admissions inappropriées, tout en répondant à la fois aux besoins psychiatriques et aux déterminants sociaux de la santé dans un contexte de soins aigus. Lors de la recension des écrits, nous avons trouvé peu de recherches permettant d’informer la mise en oeuvre des soins virtuels dans les services d’urgence canadiens (Hensel et coll., 2020;Serhal et coll., 2017). Plus précisément, il n’existe pas de recherche concernant un modèle de soins psychiatriques et sociaux collaboratifs dans un contexte de pandémie mondiale. D’autres études approfondies au sujet des milieux psychiatriques d’urgence utilisés comme sites de prévention des crises en santé mentale sont nécessaires.

Anxiety and depressive symptomatology among children and adolescents exposed to the COVID-19 pandemic - A systematic review

Background/Aim. Children and adolescents are sensitive groups for the development of mental disorders during the crisis. The aim of this systematic review was to assess the impact of the COVID-19 pandemic on anxiety and depressive symptomatology in the population of children and adolescents. Methods. The investigation was based on a systematic review followed by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, including Ovid MEDLINE, Embase, Global Health, and APA Psyc Info databases, to identify relevant studies reporting anxiety and depressive symptoms among children and adolescents during the COVID-19 pandemic. A total of 27 articles were included. Results. Anxiety symptoms increased from 28.3% before the pandemic to 49.5% during confinement [General Anxiety Disorder (GAD)-7 = 11)] (McNemar test, p < 0.0001). More depressive symptomatology was found, as well as weight and sleep disturbances which are the characteristics of children and adolescents' mental health. Additionally, female teenagers were experiencing grater declines in mood disorders than male teenagers during the COVID-19 crisis. On the one hand, different positive correlations between anxiety and other variables, were found, such as clinical depressive symptoms and anxiety (3/14), smartphone and internet addiction (2/14), lower levels of family income (2/14), perceived threats (2/14), higher grades at school (2/14), and loneliness (1/14). On the other hand, positive correlations were reported between depression and children and adolescents that were socially disconnected (3/17). Finally, mothers with higher level of education and income were associated with higher level of happiness (2/17). Conclusion. COVID-19 has a strong impact on the mental health of children and adolescents regarding depression and anxiety symptoms. Prevention programs focused on coping strategies should be conducted in elementary schools, middle schools, and high schools. Mental health should become a priority matter for governments, and the current pandemic could be an opportunity to highlight the importance of mental well-being and to invest in the betterment of clinical trainings, treatments and mental health research. (English) [ FROM AUTHOR] Uvod/Cilj. Deca i adolescenti su osetljiva grupa za razvoj psihičkih poremećaja tokom krize. Cilj ovog sistematskog pregleda literature bio je da se proceni uticaj pandemije COVID-19 na razvoj simptoma anksioznosti i depresije u populaciji dece i omladine. Metode. Sistematski pregled literature je urađen pomoću PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protokola, uključujući Ovid MEDLINE, Embase, Global Health i APA Psyc Info baze podataka, u cilju identifikovanja relevantnih istraživanja o simptomima anskioznosti i depresije kod dece i adolescenata u toku pandemije COVID-19. Pregledano je 27 radova. Rezultati. Simptomi anksioznosti su se povećali sa 28,3% pre pandemije na 49,5% tokom „zatvaranja" usled pandemije [General Anxiety Disorder (GAD)-7 = 11)] (McNemar test p < 0,0001). Ustanovljen je i skok u simptomima depresije, kao i u telesnoj masi i poremećajima spavanju, koji karakterišu smetnje u mentalnom zdravlju dece i adolescenata. Poremećaj raspoloženja (pad) je bio veći kod tinejdžera ženskog, u odnosu na tinejdžere muškog pola. Pokazane su pozitivne korelacije između anksioznosti i drugih varijabli: kliničkih depresivnih simptoma i anksioznost (3/14), zavisnosti od pametnih telefona i interneta (2/14), nižeg porodičnog prihoda (2/14), percipirane opasnosti (2/14), viših razreda u školi (2/14), i usamljenosti (1/14). Pokazane su i pozitivne korelacije između depresije i socijalne isključenosti dece i adolescenata (3/17). Konačno, pokazana je povezanost između majki sa višim nivoima obrazovanja i prihoda i osećanja sreće (2/17). Zaključak. Pandemija COVID-19 ima snažan uticaj na mentalno zdravlje dece i adolescenata odnosno pojavu simptoma depresiije i anksioznosti. Zbog toga bi u osnovnim, srednjim i višim školama trebalo sprovoditi programe prevencije, sa fokusom na razvoj strategija prevladavanja. Mentalno zdravlje bi trebalo da postane prioritetna tema vlada zemalja, a trenutna pandemija mogućnost da se istakne važnost brige o mentalnom blagostanju i ulaganja u poboljšanje kliničkih treninga, tretmana i istraživanja u oblasti mentalnog zdravlja. (Bosnian) [ FROM AUTHOR] Copyright of Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia is the property of Military Medical Academy INI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)