Anna Eremeeva – Child Psychiatrist-Drug addiction Specialist

Arkhangelsk Psychiatric Polyclinic, Arkhangelsk,

Russian Federation

Svetlana Manankova Bye – Leader of Telemedicine Cooperation

between North Norway and Northwest Russia University Hospital of North Norway, Tromsø Norway

September 28 – 29, 2017 Berlin

TELEPSYCHIATRY

FOR MENTAL HEALTH

OF CHILDREN AND ADOLESCENTS IN THE NORTH

23rd International Conference on Adolescent medicine and Child psychology

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The structure of the presentation: – background – mission and the tasks – outcomes

2016-2017

Barents Health Program, В1602 "Improving the provision of services to the population with mental

and behavioral disorders in remote areas of the Arkhangelsk region.”

RUSSIAN-NORWEGIAN PROJECT

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THE FIRST PREREQUISITE

PRIORITY OF THE RUSSIAN HEALTH CARE –

IMPROVEMENT OF INFORMATIZATION

Dmitry Medvedev

Veronika Skvortsova

Anton Karpunov

“Access to health care – is in information technologies…”

“Transition to a broad application of digital technologies

“Our region is distinguished by special conditions of the territory, which are an objective necessity for the introduction of telemedicine..”

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New “law on telemedicine”

Federal law

dated on July 29 2017

№ 242

“On the Introduction of Amendments to Certain Legislative Acts of the Russian

Federation on the Application of Information Technologies in the

Sphere of Health Protection”

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THE SECOND PREREQUISITE

REGIONAL SPECIFIC FEATURES

Climatic and geographic features Personnel features

• Shortage of medical personnel

(staffing 28%)

• Shortage of paramedical personnel

• Area – 587,4 thousand sq. km.

• Density of population – 2,0 per sq. km

• Hard to reach and remote areas

• Abundance of water barriers

5 Ten regions in the south of Russia occupy the area that equals

the area of a region in the North.

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THE THIRD PREREQUISITE

SOCIOLOGICAL SURVEY

Research objective:

Determine the opinions of prevention experts about

the system of preventing mental and behavioral

disorders in children and adolescents

Target group of research:

Experts from prevention system of the Arkhangelsk

Region

Number of responders:

546 people

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TARGET GROUPS OF RESEARCH

Healthcare workers

School teachers and psychologists

Police officers working with children

Employees of local authorities

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STUDY DESIGN

• Statistical analysis:

IBM SPSS, version 22 (SPSS Inc., Chicago, IL);

WinPEPI, version 11.1 (Copyright J.H.Abramson,

Nov. 3, 2010); OpenCode, version 4.03

• Transverse cross-sectional study

use of standardized interviews – Open questions

• Analytical triangulation - the method of validation of qualitative research data

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STUDY OUTCOMES

Categories of factors interfering preventive

psychiatric care(%)

44,6

21,9 19,4

12,6 11,2 10,4 9,4 8,6

0

5

10

15

20

25

30

35

40

45

50

Difficult accessibility of care

Note: the sum of percentages of answers exceeds 100%, respondents could give several answers 10

STUDU OUTCOMES

Proposals for improving the organization of preventive

psychiatric care (%)

28,9

21,3

18,5 17,4

13,2 11,1

9,4

3,8 3,8

0

5

10

15

20

25

30

35

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%

development of distance counseling and interdisciplinary approach in psychiatry

Note: the sum of percentages of answers exceeds 100%, respondents could give several answers

The task is to define and implement promising organizational directions for improving mental health care for the population of the Arkhangelsk region on the basis

of modern Internet technologies

Surgery… Cardiology… Neonatology…

…..BUT how to apply IT in psychiatry?

Is this possible?

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Project partner: University Hospital of North Norway

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Aim of the project В1602 “Improving the provision of services to the population with mental and

behavioral disorders in remote areas of the Arkhangelsk region”

• to improve the quality of prevention and treatment of people with mental and behavioral disorders in remote areas of the Arkhangelsk region through the development of inter-and- intra-departmental cooperation based on the introduction of information and communication technologies (ICT)

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Modern psychiatry

biopsychosocial model

Interagency approach

социогенез socio

bio psy

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Design of the project: philosophy, logo

e-health support for the mental health of northerners

Telepsychiatry is the use of information and communication technologies (ICTs) in the protection of mental health (definition from the book by Professor G. Hartvigsen)

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Objectives

«Pomor Model»=Psychiatrists + GP (synergy of projects)

Testing interaction network

PREPARATION OF pilot districts (4)

EXPERT NETWORK

DEPARTMENT – Unit for remote work

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DISSEMINATION OF EXPERIENCE.

Administration of remote districts (“Conductors”)

Teachers, psychologists… (“Conductors”)

Vulnerable groups of population… Children, parents…

Primary health care workers (“Conductors”)

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Target groups

«Conductors» require support

“Conductors” – project participants

MOST IMPORTANT PEOPLE IN THE PROJECT! Main task: Support and coordination of distance work locally: - Administrative - Professional - Technical

Challenges : -- organizational --motivational - technical

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Study Visits

After the first study visit Сontent • School of loving parents • Autism • «Pomor model» (Synergy with an

existing project)

After the second study visit Forms of work • Web-site, panic button • Mobile application • Short video films, webinars • Web-consultations

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Model of information flows

Parents

Arkhangelsk Psychiatric Polyclinic

Regional administration,

politicians

Municipalities administration

Healthcare workers

Teachers, Psychologists

Direct communication: face-to-face meetings Internet, Web-pages, programmes

Feedback: face-to-face meetings, videoconferences, e-mail – delayed off-line consultations, on-line consultations

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Unit for Remote Work

Web-site as an instrument of communication

http://29apnd.ru/ 22

School of Loving Parents psychopreventional programme

• Helps to find harmonious relationships in the family

• The programme is very popular

• Distance learning and support for specialists in the creation of such schools

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Autism: web page ASD, community, communication

CARS — Childhood Autism Rating Scale

Downloading the questionnaire

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Web page “Crisis conditions”

• Videolectures

• Webinars for specialists

• Forum for adolescents, questions to psychologists

• Great demand

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Panic button

short-term psychological counseling

(one or more letters)

format of scribotherapy - therapy by writing

(unlimited number of letters)

E-Mail-consultation of a psychologist

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Increase of web-site traffic and population involvement

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Remote areas give positive feedback on the e-health elements implementation

The work will be continued after the end of the project as a section of our daily activities 29

Летим вместе в будущее!

Flying together to the future!

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