About the Project
The aim of the eCap project is to surmount the challenges in the delivery of mental health services to adolescents and children in remote areas.
The need for psychiatric services for children and adolescents generally exceeds service capacity.
The eCAP project aims to solve problems in the delivery of mental health promotion and child and adolescent psychiatry services to remote areas. The main problems are insufficient numbers of psychiatrists/specialists, long waiting times, limited capacity among primary care services and a heavy travel burden for both patients/their families and for outpatient specialists. This is potentially damaging in conditions which are sensitive to neurodevelopmental maturation processes.
There is a need to develop IT-based solutions which increase both the quantity and quality of the available services in peripheral areas. Furthermore, there is a need to support multiprofessional collaboration between professionals working with the children, adolescents and their families (health and social services, daycare and schools).
Goals and results
The aim of this project is to develop diagnosis, consultation, supervision, treatment and collaboration between professionals by using modern information technology - videoconferencing (VC) systems and the Development and Wellbeing Assessment (DAWBA), a computerised structured instrument for gathering diagnostic data from families, teachers and young people themselves).
This will increase the knowledge of local multiprofessional experts about mental health and mental disorders of children and adolescents. This supports both preventive work and treatment close to the child and his/her developmental environments (school, daycare etc.). The service mentioned above will use VC to bridge the distance between specialists, primary care, GPs, schools, patients and their families.
The project collaborating partner is the Child and Adolescent Psychiatry Clinic at the University Hospital of North Norway. The eCAP services are developed by the therapists at the three departments at CAP together with project managers from NSE.
Patients will be offered e-therapy, supervision and skills training in their own communities using a browser-based videoconference tool.
Videoconference consultations will be used to complement face-to-face consultations and to reach patients who oppose travelling to the hospital.
Services are also tailored to meet the needs for counselling of the patient's family as well as local therapists and other professionals contributing to the treatment of children and adolescents in their own community.
The eCAP services to be developed and tested in the Clinic’s departments are:
- The Outpatient Department will implement e-therapy using a browser-based videoconference tool. The patients will participate at the treatment sessions from the local health centre. If security issues are solved, the therapists will treat patients in their own homes.
- The Inpatient Department will use videoconference to offer skills training as well as consultations with the patients and their family. In addition, preliminary meetings and follow-up care will be offered.
- The Department for Eating Disorders will use videoconference as an integrated part of the treatment offered to the patients, their families as well as local therapists during outpatient treatment and when the patient is admitted in the ward.
The current systems through which children and young people arrive at Child and Adolescent Mental Health Services (CAMHS) are inefficient (long waiting times, inappropriate referrals, lack of information) and families could suffer as a result of this inefficiency.
We aim to find out whether use of the Development and Wellbeing Assessment (DAWBA) soon after a concern is first raised about a child’s mental health can result in improved mental health in children and young people, reduced waiting times to services, and improved appropriateness of referrals.
The DAWBA is a computerised structured instrument for gathering diagnostic data from parents or guardians, teachers and young people themselves. Referrals can come from GPs, paediatricians, health visitors, school nurses, primary mental health workers and educational psychologists.
We will ask 246 families in the north NHS Highland region to participate in a randomised controlled trial where they will either receive the DAWBA at referral, or go through the current standard assessment process (which may vary depending on the referrer and the service).
All families where there are mental health concerns about children and young people aged 2-18 years of age will be offered participation. We will collect detailed information regarding what happens to families in both groups.
The aim of the eCAP project in the Pohjois-Savo region is to improve the quality and availability of child psychiatry services by by developing consultations, supervision and multi-professional collaboration.
The planned services to be piloted in the region include an electronic booking system, a video conferencing (VC) system for professional use, and the rapid online diagnostic tool DAWBA / SDQ.
The services will be integrated in the daily work at the KUH Clinic of Child Psychiatry and in the treatment chain with the basic level (primary health care, daycare, schools, social care etc.) in the municipalities.
The development activities start with a baseline survey and meetings in the municipalities (spring 2016), and will continue with developing and launching the booking system, VC services and DAWBA practices (autumn 2016).
In addition, training for the staff will be organized (autumn 2016).
The implementation phase in the region is planned to be 18 months (until spring 2018), after which the evaluation and deployment of the developed services and will take place.