CURRENT STATE OF CHILD PSYCHIATRY IN UKRAINE: EDUCATION AND PRACTICE

Authors

  • D.I. Martsenkovskyi

DOI:

https://doi.org/10.32782/umv-2023.1.6

Keywords:

Ukraine, child, adolescent, war, pandemic, mental health.

Abstract

The article discusses the challenges that Ukrainian paediatric mental health services faced during the COVID-19 pandemic and the full-scale invasion of military forces to Ukraine. The features of the psychiatric service organization, such as the concentration of these services in large cities exacerbated by the staff shortages, lowlevel telehealth facilities development, and lack of mental health education on the community level that were exacerbated by stigma in the society negatively affected the access to specialized child mental health services during the pandemic. The situation significantly worsened due to war, that was related to the unprecedented rate of violence toward the civil population, destruction of critical infrastructure, lack of access to medication, and evacuation of medical personnel that in turn resulted in a crisis in Ukrainian child and adolescent psychiatry To address these challenges, a recent paper highlight the need for systemic reforms and collaboration among experts in the field of child healthcare, medical education, social services, and government agencies. The author recommends creating a comprehensive training program for child psychiatrists and incorporating child psychiatry into the postgraduate training of medical professionals, providing training in child psychiatry for pediatricians and family doctors and promoting digital services. Furthermore, the authors propose deinstitutionalization for child psychiatric services and their movement to multidisciplinary childcare facilities with the developing of community- based forms of psychiatric and psychological care for children to ensure better access to mental healthcare services and their destigmatization.

References

Attanayake, V., McKay, R., Joffres, M., Singh, S., Burkle, F., Jr, & Mills, E. (2009). Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Medicine, conflict, and survival, 25(1), 4–19. URL: https://doi.org/10.1080/13623690802568913.

Baranne, M. L., & Falissard, B. (2018). Global burden of mental disorders among children aged 5–14 years. Child and adolescent psychiatry and mental health, 12(1), 1–9. URL: https://doi.org/10.1186/ s13034-018-0225-4.

Barican, J. L., Yung, D., Schwartz, C., Zheng, Y., Georgiades, K., & Waddell, C. (2022). Prevalence of childhood mental disorders in high-income countries: A systematic review and meta-analysis to inform policymaking. Evidence-Based Mental Health, 25(1), 36–44.

Borschmann, R., Greenberg, N., Jones, N., & Henderson, R. C. (2014). Campaigns to reduce mental illness stigma in Europe: a scoping review. Die Psychiatrie, 11(01), 43–50.

Bronsard, G., Alessandrini, M., Fond, G., Loundou, A., Auquier, P., Tordjman, S., & Boyer, L. (2016). The prevalence of mental disorders among children and adolescents in the child welfare system: A systematic review and meta-analysis. Medicine, 95(7). URL: https://doi.org/10.1097/MD.0000000000002622.

Cunningham, N. R., Ely, S. L., Barber Garcia, B. N., & Bowden, J. (2021). Addressing Pediatric Mental Health Using Telehealth During Coronavirus Disease-2019 and Beyond: A Narrative Review. Academic pediatrics, 21(7), 1108–1117. URL: https://doi.org/10.1016/j.acap.2021.06.002

Dimitry L. (2012). A systematic review on the mental health of children and adolescents in areas of armed conflict in the Middle East. Child: care, health and development, 38(2), 153–161. URL: https://doi. org/10.1111/j.1365-2214.2011.01246.x.

Gilman, R., Strawn, J. R., & Keeshin, B. R. (2015). Clinical tools for the prevention and treatment of childhood and adolescent PTSD. Current Treatment Options in Psychiatry, 2(1), 99–111.

Gnanavel, S., Sharma, P., Sebela, A., Alemany, T., Chang, J., De Medeiros Filho, M., . . . Tan, M. (2020). Child and adolescent psychiatry training curriculum: A global trainee’s perspective. BJPsych International, 17(3), 69–71. doi:10.1192/bji.2020.8.

Hamilton J. (2021). Feasible evidence-based practice in child and adolescent mental health. JM Rey’s IACAPAP e-Textbook of Child and Adolescent Mental Health. International Association for Child and Adolescent Psychiatry and Allied Professions.

Herrman, H., Chkonia, E., Pinchuk, I., Javed, A., Sartorius, N., Skokauskas, N., & van Voren, R. (2021). The WPA responds rapidly to a mental health crisis: the Ukrainian example. World Psychiatry, 20(1), 147.

Iacobucci G. (2022). Covid-19: Pandemic has disproportionately harmed children’s mental health, report finds. BMJ 2022; 376 :o430. doi:10.1136/bmj.o430.

International Organization for Migration (IOM), March 2022. URL: https://reliefweb.int/sites/reliefweb. int/files/resources/IOM%20IDP%20Estimates%20UKR%2016MAR2022_Round%201%20full%20report_ v2.pdf.

Jaycox, L. H., Ayer, L., Vona, P., Hehman, C., Stein, B. D., Mahmud, A., Woolley, M., Meza, E., Thornton, E., & Venkatesh, B. (2019). Development and preliminary evaluation of a self-guided, internet-based tool for coping with stress and trauma: Life Improvement for Teens (LIFT). Psychological Services, 16(1), 85–94. URL: https://doi.org/10.1037/ser0000277.

John-Baptiste Bastien, R., Jongsma, H. E., Kabadayi, M., & Billings, J. (2020). The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents and young adults: a systematic review and meta-analysis. Psychological medicine, 50(10), 1598–1612. URL: https://doi. org/10.1017/S0033291720002007.

Kadir, A., Shenoda, S., & Goldhagen, J. (2019). Effects of armed conflict on child health and development: A systematic review. PloS one, 14(1), e0210071. URL: https://doi.org/10.1371/journal.pone.0210071.

Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustün, T. B. (2007). Age of onset of mental disorders: a review of recent literature. Current opinion in psychiatry, 20(4), 359–364. URL: https://doi.org/10.1097/YCO.0b013e32816ebc8c.

Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019). Principles in using psychotropic medication in children and adolescents. IACAPAP e-Textbook of Child and Adolescent Mental Health. International Association for Child and Adolescent Psychiatry and Allied Professions.

Martsenkovsky I, Martyniuk V, Ougrin D. Delivering psychiatric services in primary care: is this the right way to go for Ukraine?. Int Psychiatry. 2009;6(1):2-4. Published 2009 Jan 1.

Martsenkovsky, I. A., Pinchuk, I. Y., Martsenkovskyi, D. I., & Sukhovii, O. O. (2015). Mental health services for children and adolescents in Ukraine: the existing problems and direction of reforms. Архів психіатрії, (21, № 1), 95–100.

Martsenkovskyi, D., & Martsenkovsky, I. (2020). Challenges in the provision of mental health care to children and adolescents during the COVID-19 pandemic in Ukraine. URL: https://iacapap.org/content/ uploads/Bulletin-Issue58.pdf.

Martsenkovskyi, D., Napryeyenko, O., Martsenkovsky, I. (2020). Depression in adolescents exposed to war trauma Risk factors for development of depression in adolescents exposed to war trauma: does PTSD matter?. GLOBAL PSYCHIATRY ARCHIVES, 3(2), 227–240. doi: 10.2478/gp-2020-0018.

Martsenkovskyi, D., & Martsenkovskyi, I. (2021). Post-traumatic depressions in children and adolescents. INTERNATIONAL NEUROLOGICAL JOURNAL, 17(4), 31–39. URL: https://doi.org/10.22141/2224-0713. 17.4.2021.237601.

Martsenkovskyi, D., Babych, V., Martsenkovska, I., Napryeyenko, O., Napryeyenko, N., & Martsenkovsky, I. (2022a). Depression, anxiety, stress and trauma-related symptoms and their association with perceived social support in medical professionals during the COVID-19 pandemic in Ukraine. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii. URL: https://doi.org/10.5114/ppn.2022.114657. 25. Martsenkovskyi, D., Martsenkovsky, I., Martsenkovska, I., & Lorberg, B. (2022). The Ukrainian paediatric mental health system: challenges and opportunities from the Russo-Ukrainian war. The lancet. Psychiatry, S2215-0366(22)00148-1. Advance online publication. URL: https://doi.org/10.1016/S2215-0366(22)00148-1.

Mukolo, A., Heflinger, C. A., & Wallston, K. A. (2010). The stigma of childhood mental disorders: a conceptual framework. Journal of the American Academy of Child and Adolescent Psychiatry, 49(2), 92–198. URL: https://doi.org/10.1097/00004583-201002000-00003.

Patel, R., Irving, J., Brinn, A., Broadbent, M., Shetty, H., Pritchard, M., ... & McGuire, P. (2021). Impact of the COVID-19 pandemic on remote mental healthcare and prescribing in psychiatry: an electronic health record study. BMJ open, 11(3), e046365.

Polaha, J., Williams, S. L., Heflinger, C. A., & Studts, C. R. (2015). The Perceived Stigma of Mental Health Services Among Rural Parents of Children With Psychosocial Concerns. Journal of pediatric psychology, 40(10), 1095–1104. URL: https://doi.org/10.1093/jpepsy/jsv054.

Quirke, E., Klymchuk, V., Suvalo, O., Bakolis, I., & Thornicroft, G. (2021). Mental health stigma in Ukraine: Cross-sectional survey. Global Mental Health, 8, E11. doi:10.1017/gmh.2021.9.

Roberts, B., Makhashvili, N., Javakhishvili, J., Karachevskyy, A., Kharchenko, N., Shpiker, M., & Richardson, E. (2019). Mental health care utilisation among internally displaced persons in Ukraine: results from a nationwide survey. Epidemiology and psychiatric sciences, 28(1), 100–111. URL: https://doi.org/10.1017/ S2045796017000385.

Ruggiero, K., Price, M., Adams, Z., et al. (2015). Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry. 54(9):709–717. URL: https://doi.org/10.1016/j.jaac.2015.07.001.

Sarvet, B., Gold, J., Bostic, J. Q., Masek, B. J., Prince, J. B., Jeffers-Terry, M., Moore, C. F., Molbert, B., and Straus, J. H. (2010). Improving access to mental health care for children: the massachusetts child psychiatry access project. Pediatrics 126, 1191–1200.

Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., ... & Fusar-Poli, P. (2022). Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Molecular psychiatry, 27(1), 281–295. URL: https://doi.org/10.1038/s41380-021-01161-7.

Theberath, M., Bauer, D., Chen, W., Salinas, M., Mohabbat, A. B., Yang, J., Chon, T. Y., Bauer, B. A., & Wahner- Roedler, D. L. (2022). Effects of COVID-19 pandemic on mental health of children and adolescents: A systematic review of survey studies. SAGE Open Medicine. URL: https://doi.org/10.1177/20503121221086712.

Tkacz, J., & Brady, B. L. (2021). Increasing rate of diagnosed childhood mental illness in the United States: Incidence, prevalence and costs. Public Health in Practice, 2, 100204.

United Nations, (1948). Universal declaration of human rights. URL: https://www.un.org/en/about-us/ universal-declaration-of-human-rights.

Марценковський І. А., Марценковська І. І., & Здорик І. Ф. Проблеми охорони психічного здоров’я, зумовлені пандемією COVID-19. Неврологія, Психіатрія, Психотерапія. 2020. № 2. С. 53.

Марценковський Д.І. Клінічний поліморфізм та коморбідність психічних розладів у дітей та підлітків, що постраждали від гібридної війни на сході України. Архів психіатрії. 2017. № 23, № 2. С. 91–95.

Міністерство охорони здоров’я. (2013). Наказ про вдосконалення порядку надання психіатричної допомоги дітям № 400 від 18.05.2013. URL: https://zakon.rada.gov.ua/laws/show/z1196-13#n14.

Процик Л., Пампура І. Психологічні особливості та правовий захист дітей в період збройного конфлікту. PSYCHOLOGICAL JOURNAL. 2019. № 5(11). С. 253–267.

Published

2023-05-17

How to Cite

Martsenkovskyi, D. (2023). CURRENT STATE OF CHILD PSYCHIATRY IN UKRAINE: EDUCATION AND PRACTICE. Ukrainian Medical News, (1-2 (94-95), 30–36. https://doi.org/10.32782/umv-2023.1.6