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Collapse in child psychiatry. Aleksandra Lewandowska, national consultant: We have 168 percent more youth patients

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We should talk about the collapse a few years ago – said Dr. Aleksandra Lewandowska, MD, a national consultant for psychiatry of children and adolescents, on TVN24. She said that she compared the data on the situation in this healthcare sector from 2022 and 2019. – We have 168 percent more adolescent patients over 13 years of age, and 87 percent more children’s patients under 13 years of age – she pointed out. She also talked about what a parent can do when they notice something disturbing in their child.

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There is a shortage of doctors in child psychiatry, and the needs are increasing. Wards are overcrowded and waiting times for a psychiatrist consultation are limited National Health Fund up to a year apart. A quick visit to a child psychiatrist is only possible privately. What the system looks like and what children in need of help and their parents face, showed the reporters of “Uwagi” TVN. One of the subjects of the material, trying to arrange a private visit to a specialist, heard that it costs PLN 340, and in other places PLN 440 or PLN 480.

National consultant: We have 168 percent more youth patients

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On Saturday, on TVN24, Aleksandra Lewandowska, a doctor of medical sciences, a national consultant for child and adolescent psychiatry, was asked if we could already use the word collapse in the case of child psychiatry.

– We should be talking about the collapse a few years ago, well before the pandemic. I often emphasize that 18 years ago I started my specialization and then there was talk of a crisis in child and adolescent psychiatry, which was growing year by year, it was a dozen or so years of neglect, she said. As she added, “then came a very difficult time for all of us, a time of pandemic, armed conflict, economic crisis and, of course, what had been left unattended for years deepened even more.”

– If community care centers had not started operating at the same time, taking into account the number of children and youth patients who joined the already overloaded system, we would have, I often use the word, disaster, armageddon, really one big disaster – she emphasized.

She said she received an analysis of child and adolescent psychiatry data this week. She noted that she relies only on public benefits. “I had no access to the private sector,” she added.

As she said, she compared 2022 to the year before the pandemic, i.e. 2019. – I counted the data five times to be sure if I counted correctly. We have 168 percent more adolescent patients over the age of 13, and 87 percent more pediatric patients under the age of 13, Lewandowska said.

“In everyday clinical practice we face many dilemmas”

According to the central register of physicians of the Supreme Medical Council in Poland, we have 500 psychiatrists for children and adolescents. The national consultant was asked whether the system could work with such human resources.

– Often, in such everyday life, in everyday clinical practice, we face many dilemmas and make very difficult decisions if we have such a scale of the problem, i.e. the number of patients who joined the care and require this psychiatric care, also stationary. We now have such a situation that mainly youth wards, i.e. for patients over 13 years of age, are occupied by nearly 85 percent on average. This is a very large number, she said.

– We have such situations that when deciding whether to admit a patient, we sometimes really wonder what solution would be better. Whether in an overloaded and overcrowded ward, whether to redirect him to community care or to a home with involved parents. These are the difficulties, she explained.

National Consultant for Child and Adolescent Psychiatry: We face many dilemmas in everyday clinical practiceTVN24

How and when should a parent react

Lewandowska also said what a parent should do who suspects that something is wrong, what signals to react to and what a parent who cannot afford private therapy for over PLN 300 should do.

“We have situations like this very often, and it’s mostly, I’m sorry to say, teenagers. How many times in the everyday reality of the hospital do I encounter such feedback from teenagers: doctor, I asked my mother, father a few months ago, please sign me up to a psychologist, or “I need help” and the parent disregarded this signal – she said. “There’s a lack of sensitivity and knowledge,” she said.

– We know what a difficult situation is, we know that the wards are overloaded, but we encourage parents not to be afraid to seek help. I hear these prices, these rates, but please believe me that we are building this system anew, she continued.

National consultant for child and adolescent psychiatry about parents' approach to children in need of help

National consultant for child and adolescent psychiatry about parents’ approach to children in need of help TVN24

She noted that “very often the parents themselves do not know whether my child already needs consultation with a psychologist or perhaps with an environmental therapist or a doctor.” “It turns out that virtually 70 percent of those patients who come in need only therapeutic care,” she said. “But 30 percent need to be redirected to the second level,” she added. She explained that these were situations in which the help of a psychiatrist or referral to a ward was necessary.

– What is a parent to do with a child, with a teenager who is in crisis? continued the national consultant. She explained that if we are dealing with a child’s declarations such as “I can’t live anymore” or we feel that something is wrong, “let’s not be afraid to come to this emergency room at the hospital.” She emphasized that help can also be sought in the community care center. Their list, she added, can be found on the NFZ website.

Aleksandra Lewandowska, national consultant for child and adolescent psychiatry.  All the talk about problems in the system

Aleksandra Lewandowska, national consultant for child and adolescent psychiatry. All the talk about problems in the systemTVN24

What do children and young people report? “The main cause is environmental factors”

When asked why such an increase in the number of patients and what problems they report, she appealed to look at “what is happening with our children, with our teenagers”. – The growing number of suicidal behaviors is feedback, a loud cry from our children and teenagers to us adults (…), so that we really bend over and change this reality, at least try to change it, which is difficult for kids – she assessed.

She reported that the main reason for the complaints is a “crisis in relations”. – Crisis in family relations, crisis in peer relations. Most of our hospitalized patients are not diagnosed with severe mental disorders. This is a really small percentage. The majority of patients are patients with diagnoses where environmental factors are the main cause – she pointed out.

She said that the parent reports that the child has not wanted to go to school for two or three months because “too much demands, because the stress he experiences every day, because of peer violence, because of violence at home.” – These are the most common reasons for both reports and hospitalizations of our patients – added Lewandowska.

If you are experiencing emotional problems and would like advice or support, here you will find a list of organizations offering professional help. In a life-threatening situation, call 997 or 112.


Main photo source: TVN24

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