Bullying is a serious problem in schools because of the negative impact on a child’s educational outcomes, especially academic achievement. However, the underlying mechanisms and causes are unknown.

To evaluate the educational outcomes, and psychiatric comorbidities in children and adolescents who are victims of bullying

We used 2018–2019 Nationwide Survey of Children’s Health (NSCH) dataset for the study. The participants were children and adolescents (age: 6-17 years, n = 42,790). Data was stratified into two groups: 1) never bullied 2) bullied more than once. Prevalence of different educational outcomes were compared between the groups.

In the never bullied group 21,015 participants were included, and in the bullied more than once group 21,775 participants were included. More females were in the bullied group compared to never bullied group (50.4% vs 47.5%, p=0.006). More White non- Hispanic individuals were in bullied group in contrast to never bullied group (56.7% vs 43.9%, p< 0.001). Individuals whose health status was fair, or poor were bullied more (2.4% vs 1.4%, p=<0.001). Individuals in bullied group were more likely to be repeating the grades compared to the never bullied group (7.1% vs 5.9%, p:0.039). Individuals who were missing >=11 school days, and sometimes or never engaged in school were observed more in bullied group compared to never bullied group (5.9% vs 3.2% and 20.3% vs 10.6% p < 0.001).

Our findings suggest that bullying victimization could be a risk factor and associated with decreased academic outcomes.

No significant relationships.

In response to COVID-19, paediatric providers have shifted to providing outpatient health care appointments through telehealth.

While research has been published previously on this topic, we felt it important to add current Canadian youth perspectives to the mix, specifically on changes due to COVID-19.

Semi-structured discussions were held on virtual care in June and October 2020 with our youth members, who are patients with various health conditions, aged 13 to 19 years which allowed us to glean their unique opinions regarding virtual care in the midst of a pandemic.

Youth who contributed to this commentary reported that major benefits of virtual care included time savings, ease of access, continuity of care, and ability to participate in health appointments from the comfort of one’s own home without a risk of COVID-19 exposure. These youth also recognized limitations to virtual care, including the inability to complete laboratory or imaging tests, and the lack of physical examination capabilities.

Additionally, they stressed the importance of visual components of virtual appointments and health care providers needing to consider privacy restrictions youth may have. Overall, our cohort of youth feel positive about virtual care and hope care providers can work with youth individually to determine the best solution for them.

No significant relationships.

As part of the full-sized personal examination of persons, living in residential facilities for mentally disabled people (Kekelidze, 2020) 621 children, living in 3 asylums “for children with mental retardation” of Krasnoyarsk region were examined. In 134 cases diagnosis “Moderate or severe mental retardation” wasn’t confirmed. In 2020 a full examination of 47 children with non-confirmed diagnoses was carried out in one of the asylums.

The main purpose of this investigation is to present the results of this full examination and sum up the main problems of the system of institutional care for children with intellectual and developmental disabilities in Russia.

Clinical and psychological examination, Wechsler Intelligence Scale for Children (WISC-II), analysis of pedagogical characteristics.

Figure 1 presents the results of cluster analysis of WISC-II. In 37 cases diagnoses were reversed to Mild intellectual disability. In one case – 10 y.o. boy - to developmental delay through social-pedagogic neglect.

In the beginning of 2021 32 children were transferred to boarding schools with educational programme for children with mild intellectual disabilities. 13 children adapted to new developmental and educational conditions relatively successfully, 4 children – unsuccessfully and were returned to the first institute.

The success of adaptation did not depend on IQ, but on the age of the child and the severity of emotional and behavioral disorders, as well as on the willingness of the institution to provide personalized assistance to the child. The results identify the main problems of the system of institutional care for children with developmental disabilities in Russia.

No significant relationships.

Underutilisation of mental health services among migrant youth has been demonstrated repeatedly, but little is known about potential discrepancies in terms of treatment receipt for those who do reach services. This study examines the type and level of care received among migrant children and descendants of migrants, particularly investigating disparities in treatment receipt given a specific diagnosis.

We used register data of the total population aged 6–17 years in Stockholm, followed from 2006 to 2015, comprising 444 196 individuals, categorised as refugees, non-refugee migrants, descendants of migrants and Swedish-born. To identify recommended treatments for specific diagnoses we used official clinical guidelines. We report logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) of diagnosis receipt, treatment provision and level of care where a diagnosis was first registered.

Migrant children had a lower likelihood of receiving a wide range of psychiatric diagnoses, including mood disorder (OR 0.58; 95% CI 0.52–0.64), anxiety disorder (OR 0.62; 95% CI 0.57–69) and neurodevelopmental disorder (OR 0.59; 95% CI 0.55–0.63). Moreover, when these diagnoses were set, migrant children had a lower likelihood of receiving the recommended treatments for these conditions compared to the majority individuals with the same diagnosis (OR of receiving psychotherapy for anxiety disorder and depression: 0.71; 95% CI 0.62–0.95 and 0.50; 95% CI 0.33–0.75, respectively; OR for receiving ADHD-medication: 0.49; 95% CI 0.43–0.54).

Migrant children risk underdiagnosis of various mental health conditions, and, when reaching mental health services, risk not receiving the optimal care available.

Consumer satisfaction is considered one of the most important measures of service quality in child mental health; however, there is limited understanding of factors that influence satisfaction. The objective of this study was to investigate key factors influencing satisfaction with care (SWC) in ADMiRE, a specialist service for young people (YP) with attention deficit hyperactivity disorder (ADHD).

Parents/carers (n = 67) and YP > 9 years (n = 44) attending ADMiRE completed an anonymous Experience of Service Questionnaire (ESQ), a quantitative/qualitative measure of service user satisfaction. Parents/carers also completed symptom severity rating scales. Data were analysed to determine (i) overall SWC, (ii) the relationship between parent- and youth-reported SWC and (iii) the impact of symptom severity on SWC. Thematic analysis of qualitative ESQ data was completed.

Parents/carers were significantly more satisfied than YP (p = 0.028). Symptom severity did not impact significantly on parent/carer satisfaction. YP with severe hyperactive/impulsive and inattentive ADHD symptoms were significantly less satisfied with care than those with less severe ADHD symptoms (p = 0.022 and p = 0.017 respectively). Factors related to the therapeutic alliance were identified as being particularly important to both parents/carers and YP.

This is the first Irish study that has investigated the impact of symptom severity on service user satisfaction in a child mental health service. The results highlight the different perspectives of YP and parents and provide novel insights into the impact of symptom severity on service user satisfaction. The importance of the therapeutic alliance should not be underestimated in future development of services.

Depression is thought to be associated with lower subsequent educational attainment during school. But, without longitudinal studies which take account of prior attainment and other potential confounders, estimates of the impact of clinically recognised depression in childhood and early adolescence are unknown. We investigated whether a clinical diagnosis of depression is associated with lower subsequent educational attainment, and whether the association is modified by gender, ethnicity and socioeconomic status.

We conducted a secondary analysis of an existing administrative data linkage between national educational data and a large mental healthcare provider in London, UK (2007–2013). Depression diagnosis before age 15 (exposure) was measured from electronic health records, and subsequent educational attainment at age 15–16 (outcome) was measured from educational records. We fitted logistic regression models and adjusted for gender, ethnicity, socioeconomic status, relative age in school year, neurodevelopmental disorder diagnosis and prior attainment. We investigated effect modifiers using interaction terms.

In total, n = 63 623 were included in analysis, of whom n = 242 had record of a depression diagnosis before age 15. Depression was associated with lower odds of subsequently achieving expected attainment levels in national exams, after adjustment for all covariates (odds ratio = 0.60, 95% confidence interval = 0.43 to 0.84, p = 0.003). There was no evidence that gender, ethnicity or socioeconomic status modified this association.

These findings support a relationship between depression and lower subsequent educational attainment. This highlights the need for tailored educational interventions to support children and adolescents with depression, particularly in the lead up to key educational milestones.

Although of great value to understand the treatment results for mental health problems obtained in clinical practice, studies using naturalistic data from children and adolescents seeking clinical care because of complex mental health problems are limited. Cross-national comparison of naturalistic outcomes in this population is seldomly done. Although careful consideration is needed, such comparisons are likely to contribute to an open dialogue about cross-national differences and may stimulate service improvement. The aim of this observational study is to investigate clinical characteristics and outcomes in naturalistic cohorts of specialized child and adolescent mental health outpatient care in two different countries.

Routinely collected data from 2013 to 2018 of 2715 outpatients in the Greater Area of Brisbane, Australia (CYMHS) and 1158 outpatients in Leiden, the Netherlands (LUMC-Curium) were analysed. Demographics, clinical characteristics and severity of problems at start and end of treatment were described, using Children's Global Assessment Scale (CGAS), Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the parental Strength and Difficulties Questionnaire (SDQ-P).

Routine outcome measures (CGAS, HoNOSCA, SDQ-P) showed moderate to severe mental health problems at start of treatment, which improved significantly over time in both cohorts. Effect sizes ranged between 0.73-0.90 (CYMHS) and 0.57-0.76 (LUMC-Curium). While internalizing problems (mood disorder, anxiety disorder and stress-related disorder) were more prevalent at CYMHS, externalizing developmental problems (ADHD, autism) prevailed at LUMC-Curium. Comorbidity (>1 diagnosis on ICD10/DSM-IV) was relatively similar: 45% at CYMHS and 39 % at LUMC-Curium. In both countries, improvement of functioning was lowest for conduct disorder and highest for somatoform/conversion disorders and obsessive-compulsive disorders (OCD). Overall, 20-40% showed clinically significant improvement (shift from clinical-range at start to a non-clinical-range at the end of treatment), but nearly half of patients still experienced significant symptoms at discharge.

This large-scale outcome study showed both cohorts from Australia and the Netherlands improve during the course of treatment on clinician- and parent-reported measures. Although samples were situated within different contexts and differed in patient profiles, they showed similar trends in improvement per diagnostic group. While 20-40% showed clinically significant change, many patients experienced residual symptoms reflecting increased risk for negative outcome into adulthood. We emphasize cross-national comparison of naturalistic outcomes faces challenges, although it can similarly reveal trends in treatment outcome providing direction for future research: what factors determine discharge from specialized services; and how to improve current treatments in this severely affected population.

The associations between suicidal behaviours and childhood maltreatment (CM), as well as Internet addiction (IA) have been extensively examined. However, few studies pay attention to different types of CM and all stages of suicidality, including suicidal ideation (SI), suicidal plans (SP) and suicidal attempts (SA). Moreover, little is known regarding the mediation of IA on the relationship between CM and suicidal behaviours. The study aims to explore the direct effect of CM and IA on three stages of suicidal behaviours, and the indirect effect of CM on suicidality via IA.

A total of 16 130 high-school students aged 12–18 were recruited using a stratified cluster sampling strategy across five representative provinces in China. Relevant information was collected by a self-administered anonymous questionnaire. Multinomial logistic regression analysis and structural equation model were used to examine the associations.

During the last year, 16.0% of participants reported suicidal behaviours. Specifically, 7.9% reported SI only, 4.6% reported SP but no SA, and 3.5% reported SA. The prevalence of neglect, physical abuse and IA in moderate to severe were 28.9, 19.9 and 33.1%, respectively. After controlling for demographic characteristics and confounding factors, such as loneliness, psychological resilience, and social support, moderate and severe neglect, physical abuse and IA were associated with an increased risk of SI, SP and SA (p < 0.01). The total effect of neglect and physical abuse on suicidal behaviours were 0.152 and 0.172, respectively (p < 0.001). The mediation proportion of IA on the association between neglect and suicidal behaviours, as well as physical abuse and suicidal behaviours were 22.4 and 18.0%, respectively.

CM and IA are independently associated with suicidal behaviours among Chinese adolescents. Moreover, IA plays a mediating role on the relationship between CM and suicidality. Targeted interventions for adolescents’ suicidal behaviours should focus on those who have experience of CM and IA.

Covid-19 intensified public demand for telehealth services in child psychiatry. The shift towards online services raised concerns related to safety and quality of services.

The objective of the study was to explore outcomes and perceptions regarding psychiatric telehealth services from the patients’ and professionals’ perspectives.

Survey and questionnaires were the main methods to collect feedback after 1129 sessions conducted by psychiatrists and psychotherapists for 559 young patients in 2020.

Overall, patients/caregivers were generally satisfied with the quality of services, despite some technical issues and limitations of the platform. The most common outcomes of the sessions were: psychotherapy, in-depth assessment, pharmacotherapy, in-patient treatment, referrals for in-person appointments with other specialists, parenting strategies. Professionals gave more positive feedback on telehealth services after a few months of practice and training. Psychiatrists preferred conducting telehealth appointments for the patients they have previously seen in-person. The most common diagnosis were various neurodevelopmental disorders (48,9%), as well as patients within F84.0-F84.5 27,9%, and F84.8 (19,8%). Identification challenges, confidentiality and safety maintenance were among the top concerns for mental health workers. Specific guidelines for caregivers helped to use the appointment time effectively, prevent some technical and organizational issues and decrease negative effects of limited communication capabilities during a telehealth appointment.

Telehealth services in psychiatry are meeting real needs of patients, caregivers and professionals, and require further development. Proper training for professionals and clear guidelines for caregivers are among the key factors that enhance the quality of services.

Children with Autism Spectrum Disorder (ASD) struggle with communication, sensory sensitivities and social interaction. These difficulties can make hospital visits challenging. Every child with ASD is unique, and as such, some children can do well in clinical settings with minimal supports while others may require environmental modifications to achieve optimal care. ASD is prevalent worldwide and cultural differences can lead to varied care. Several hospitals, including Boston Medical Center in USA and Sidra Medicine and Research Center in Qatar, have attempted to address these challenges by developing strategies to create an ‘Autism Friendly’ environment.

This workshop will 1. Describe the 4 domains of an “Autism Friendly” environment 2. Describe practical steps for successful implementation of interventions and modifications to consider based on setting and culture.

Didactic section 1 will describe the 4 domains for greating an ‘Autism Friendly environment’. Didactic section 2 will describe implementation in an inpatient and outpatient setting focusing on modifications based on environmental differences. These didactic presentations will be followed by a hands on, interactive section where participants will break out in small groups to learn specific implementation skills.

Participants will learn how to improve care offered to children with ASD during hospital visits. Participants will develop the skills to implement similar interventions in their home institutions.

Hospitals can create an Autism Friendly environment by using 4 domains of intervention which could help improve provider skills and patient and family experience.

Collaboration between psychiatrists and psychologists (counsellors) is one of the key factors impacting efficiency of services in child and youth mental health. Despite the clear benefits, a teamwork approach is still limited and has some difficulties.

The objective of the study was to explore potential barriers in the collaboration between professionals with different backgrounds.

Anonymous online survey for staff from various mental health clinics across Russia was completed by 142 psychologists and 70 psychiatrists (Σ =212).

77.7% participants reported that collaboration is helpful in adult mental health services; 91.3% see partnership as an essential part of child and youth mental health. 61.6% specialists work together; 44.7% described it as a successful experience. At the same time 58.4% believe that pharmacological treatment should start first, and counselling may be postponed. 49.5% believe that doctors often diminish the importance of counselling. Fears and biases towards psychiatrists were reported by 28.9% of the sample. 25.4% participants reported lack of trust and limited understanding of counselling methods. Top barriers for collaboration that were reported: lack of opportunities on an organizational level (20% doctors and 45% psychologists), unclear professional boundaries and responsibilities (28.5% doctors and 15.4% psychologists), lack of motivation (20% doctors and 7% psychologists), lack of positive experience (11.2% psychologist and 0% doctors). The main reported benefit of collaboration by 39.6% was improved compliance and better treatment outcomes.

In order to make collaboration among mental health professional more efficient, there is a need to address the barriers listed above.

Children with mental health issues are heavily dependent upon the attitude of their caregivers towards disease control and prevention. There is also a high risk of COVID-19 outbreaks in the mental health clinics (hospitals) for children.

Children with mental health issues are heavily dependent upon the attitude of their caregivers towards disease control and prevention. There is also a high risk of COVID-19 outbreaks in the mental health clinics (hospitals) for children.

The data from the Municipal Department of Health and Medical records of patients who were treated at the clinic from January to June in 2019 were compared. Statistical processing was carried out using the Chi-Square for 2 x 2 Contingency Table method.

The study demonstrated the statistically significant difference in the types of mental health conditions that require more attention and in-patient emergency treatment options during the pandemic, including decompensation, exacerbation or manifestation of endogenous diseases, anorexia nervosa and suicidal manifestations. To prevent the spread of infection, a specific separate clinical unit was created for patients with severe mental health disorders and symptoms of COVID-19. Additionally, multiple changes were implemented in treatment protocols, staff duties and interactions with the patients’ caregivers.

There was a higher demand for in-patient emergency treatment for children with severe mental health disorders in 2020, as compared to 2019. Timely introduced anti-epidemic measures made it possible to avoid outbreaks of COVID-19 in the children’s psychiatric hospital.

In the context of the Covid-19 pandemic, healthcare workers experienced significant distress. At the same time, concern for the safety and well-being of employees remained important priorities to ensure the quality of care for children with mental illness.

To study the specifics of the experience of the Covid-19 pandemic among employees of a children’s psychiatric clinic, highlight the existing among them attitudes about the pandemic and form administrative decisions to improve the quality of care for children.

380 employees voluntarily took part in the study (group 1 (G1): 115 people who worked directly with Covid-19 and group 2 (G2): 265 people without this experience) from 05/18/2020 to 05/20/2020. The author’s questionnaire included the following blocks: 1) attitude towards patients and colleagues; 2) emotional experiences; 3) ways of coping; 4) social support; 4) finance.

The main motive when deciding to work with Covid-19 was the motive of professional duty (25.4% of participants). There are a number of significant differences between group 1 and group 2: participants in G1 are characterized by denial of special experiences associated with Covid-19, seeking help from colleagues in difficult working conditions, reliance on family members and a positive vision of administrative decisions significantly more than participants G2. Relatives of G1 participants are less concerned about their future and health.

The personnel decisions made on the basis of the research allowed the clinic’s team to provide quality care to children and families throughout the pandemic.

Marriages’ dissolution phenomenon had increased in recent years in Tunisia. The impact of divorce on children depends on the interweaving of several factors and is not inevitably pathological. We have noticed in our daily practice a concomitant increase in the number of request for expert opinions concerning children.

Determine the clinical children’s profile of separated parents carried out within the framework of legal expertise.

We carried out a retrospective study in the outpatient child psychiatry ward at Fattouma Bourguiba general hospital in Monastir, Tunisia. Including all the expert reports of children affected by parental separations during a period of two years (2017 to 2019).

56 children were included in our study. The average age were (6.7 years) with a majority of males (58.2%). School failure concerned (24%). In most cases, the request for expertise was made in the context of mistreatment’s suspicion (60.7%), than following the parents’ separation (16.1%). Concerning the clinical picture: a normal psychiatric examination was found in the majority of cases (55.4%), anxiety symptoms concerned (32.1%). Cases of depression, global developmental delay and autism were also found.

According to our study, the vast majority of children presented a normal psychiatric examination. Moreover, a preponderant part of the symptoms seemed to result from educational errors. While parental separation poses risks for children, research shows that these negative effects are not the same for everyone. Several factors can reduce these risks and promote children’s resilience. Thus, first-line psychosocial care should be offered for families and children in seprations’ context.

No significant relationships.