Organisation of child and adolescent mental health care

1. INTRODUCTION AND SCOPE 12 -- 1.1. HISTORICAL CONTEXT OF THIS REPORT 12 -- 1.1.1. The Western world: de-institutionalization, the balanced care model 12 -- 1.1.2. The reforms in Belgium 12 -- 1.1.3. Context of the current report 13 -- 1.2. SCOPE OF STUDY AND RESEARCH QUESTIONS 14 -- 1.2.1. Scope 14 -- 1.2.2. Research questions 15 -- 1.3. DEFINITIONS 16 -- 1.3.1. Definition: mental health 16 -- 1.3.2. Definition: mental disorders, mental health problems 16 -- 1.3.3. Definition: camhs and specialist camhs 17 -- 1.3.4. Definition: children and adolescents 17 -- 1.3.5. Definition: ”Integrated care” 17 -- 2. METHODS 18 -- 2.1. LITERATURE REVIEW 18 -- 2.1.1. Search strategy 18 -- 2.1.2. In- and exclusion criteria 19 -- 2.1.3. Selecting studies 19 -- 2.1.4. Quality appraisal and data extraction 19 -- 2.2. INTERNATIONAL OVERVIEW 20 -- 2.2.1. Selection of countries 20 -- 2.2.2. Methodology of data collection 21 -- 2.2.3. General framework 21 -- 3. LITERATURE RESULTS: A NARRATIVE REVIEW ON ORGANIZATIONAL ASPECTS OF -- CAMHS 22 -- 3.1. INTRODUCTION 22 -- 3.2. SEARCH RESULTS & QUALITY APPRAISAL 22 -- 3.3. THE WHO MODEL 23 -- 3.3.1. WHO guidance on Policy development 23 -- 3.3.2. WHO Model components 23 -- 3.4. COUNTRY LEVEL POLICIES 24 -- 3.4.1. Policy aspects on countries (or regions) resulting from the peer-reviewed literature: -- Canada, Norway, the US 25 -- 3.5. SYSTEMS OF CARE 26 -- 3.5.1. Historical context, definition and principles 26 -- 3.5.2. Systems of care: observational studies 28 -- 3.5.3. Systems of care: Fort Bragg and Stark County studies 29 -- 3.6. PATIENT AND SERVICE LEVEL MODELS 30 -- 3.6.1. Intensive community-based interventions 30 -- 3.6.2. Specialized outpatient care as alternative to inpatient mental health 35 -- 3.6.3. School-based services 35 -- 3.7. OTHER INITIATIVES REGARDING THE ORGANIZATION OF CAMHS 36 -- 3.8. RESTRICTIONS OF THIS REVIEW 37 -- 4. LITERATURE RESULTS: A NARRATIVE REVIEW ON FUNDING AND FINANCING -- MECHANISMS OF CAMHS 45 -- 4.1. INTRODUCTION 45 -- 4.2. SEARCH RESULTS 45 -- 4.3. CHILDREN AND ADOLESCENT MENTAL HEALTH CARE: PEER REVIEWED STUDIES 45 -- 4.3.1. Peer reviewed studies camhs: Introduction 45 -- 4.3.2. Peer reviewed studies camhs: focus and funding environment 46 -- 4.3.3. Peer reviewed studies camhs: evidence 46 -- 4.4. FINANCING ISSUES OF (INTEGRATED) MENTAL HEALTH CARE: REVIEWS 47 -- 5. BELGIUM 48 -- 5.1. HISTORICAL CONTEXT OF CHILD AND ADOLESCENT MENTAL HEALTH CARE IN BELGIUM . 48 -- 5.2. GENERAL CONSIDERATIONS 49 -- 5.3. COUNTRY PROFILE AND HEALTH CARE SYSTEM 49 -- 5.3.1. Country profile 49 -- 5.3.2. Health care system 50 -- 5.4. TARGET POPULATION 50 -- 5.4.1. Age limits 50 -- 5.4.2. Epidemiologic data 50 -- 5.5. HEALTH CARE: CAMH SERVICE ORGANIZATION & STAKEHOLDERS 51 -- 5.5.1. Camhs organization: services level 52 -- 5.5.2. Stakeholders: health services level 57 -- 5.6. HEALTH CARE: CAMH POLICIES AND POLICY STAKEHOLDERS 57 -- 5.6.1. Health care: Policy stakeholders 57 -- 5.6.2. Health care: camh policies 58 -- 5.7. NEIGHBOURING SECTORS 60 -- 5.7.1. Social care and youth welfare 60 -- 5.7.2. Juvenile justice 64 -- 5.7.3. Disability care 65 -- 5.7.4. Education 66 -- 5.8. FINANCING AND FUNDING 68 -- 5.8.1. Introduction 68 -- 5.8.2. Funding mechanisms on the federal government 68 -- 5.8.3. Funding mechanisms of the federated entities 71 -- 5.9. INTRA- AND INTER-SECTOR COLLABORATION 73 -- 5.10. NEEDS ASSESSMENT, WORKFORCE TRAINING, KNOWLEDGE DEVELOPMENT 74 -- 6. INTERNATIONAL OVERVIEW 76 -- 6.1. INTRODUCTION 76 -- 6.1.1. General methodological considerations 76 -- 6.1.2. Structure of the next sections 76 -- 6.2. HE NETHERLANDS 77 -- 6.2.1. Country profile 77 -- 6.2.2. Dutch health care system 77 -- 6.2.3. Child and adolescent mental health policy: policy plans and inter-sector collaboration at the -- policy level 77 -- 6.2.4. Camhs organization in the health care sector 78 -- 6.2.5. Neighbouring sectors 79 -- 6.2.6. Financing and funding of camhs 81 -- 6.2.7. Intra- and inter-sector collaboration 81 -- 6.2.8. Needs assessment, workforce training, knowledge development 82 -- 6.2.9. Main criticisms 82 -- 6.3. CANADA (BRITISH COLUMBIA) 84 -- 6.3.1. Country profile 84 -- 6.3.2. Health care system 85 -- 6.3.3. Child and adolescent mental health policy: inter-sector collaboration at the policy level and -- policy plans 85 -- 6.3.4. Camhs organization in the health care sector 86 -- 6.3.5. Neighbouring sectors 88 -- 6.3.6. Financing and funding of camhs 90 -- 6.3.7. Intra- and inter-sector collaboration 90 -- 6.3.8. Needs assessment, workforce training, knowledge development 90 -- 6.3.9. Main criticisms 91 -- 6.4. ENGLAND (UK) 92 -- 6.4.1. Country profile 92 -- 6.4.2. Preliminary remark 92 -- 6.4.3. Health care system 92 -- 6.4.4. Child and adolescent mental health policy: policy plans and inter-sector collaboration at the -- policy level 92 -- 6.4.5. Camhs organization in the health care sector 93 -- 6.4.6. Neighbouring sectors 94 -- 6.4.7. Financing and funding of camhs 96 -- 6.4.8. Intra- and inter-sector collaboration 97 -- 6.4.9. Needs assessment, workforce training, knowledge development 97 -- 6.4.10. Main criticisms 98 -- 6.5. AN EXAMPLE IN FRANCE: L’ EPSM LILLE-METROPOLE IN NORD PAS DE CALAIS 100 -- 6.5.1. Organization of health and mental health care in France 101 -- 6.5.2. CAMHS offered by the EPSM Lille-Métropole 102 -- 6.6. GENERAL OVERVIEW: THE NETHERLANDS, CANADA(BC), ENGLAND, BELGIUM 104 -- 7. DISCUSSION 110 -- 7.1. NO REFORM WITHOUT GLOBAL FRAMEWORK 110 -- 7.2. ASPECTS OF CAMHS ORGANISATION 111 -- 7.3. CAMHS AND EDUCATION ARE FACING COMMON CHALLENGES AND COULD LOOK FOR -- INTEGRATED ANSWERS 112 -- 7.4. RETHINKING FUNDING STRATEGIES TO ALLOW FOR CHANGE 112 -- 7.5. WITHOUT MONITORING AND FEED-BACK ANY REFORM WILL SOON LOSE TRACK 112 -- 7.6. A GLOBAL CAMHS FRAMEWORK WILL NOT STAND WITHOUT A QUALITATIVE CAMHS -- WORKFORCE. 113 -- 7.7. LIMITATIONS OF THE CURRENT STUDY 113 -- 8. REFERENCES 114

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