RESUMEN

The prevalence of mental health problems among children and adolescents in Western countries is high. Belgium, like many other Western countries, struggles with the set-up of a coherent and effective strategy for dealing with this complex societal problem. This paper describes the development of a policy scenario for the organization of child and adolescent mental health care services (CAMHS) in Belgium. The development process relied on Soft Systems Methodology including a participatory process with 66 stakeholders and a review of the existing (inter-)national evidence. A diagnostic analysis illustrated that the Belgian CAMHS is a system in serious trouble characterized by fragmentation and compartmentalization. A set of 10 strategic recommendations was formulated to lay down the contours of a future, more effective CAMHS system. They focus on mastering the demands made on scarce and expensive specialized mental health services; strengthening the range of services - in particular for those with serious, complex and multiple mental health problems - and strengthening the adaptive capacity of and the ethical guidance within the future CAMHS system.

Asunto(s)

Servicios de Salud del Adolescente/organización & administración , Servicios de Salud del Niño/organización & administración , Reforma de la Atención de Salud , Servicios de Salud Mental/organización & administración , Adolescente , Bélgica , Niño , Femenino , Necesidades y Demandas de Servicios de Salud , Investigación sobre Servicios de Salud , Humanos , Masculino , Innovación Organizacional , Política Organizacional

RESUMEN

BACKGROUND: Despite a high prevalence of mental health problems among children and adolescents Belgium, like many other Western countries, does not have a clear strategy for the organization of child and adolescent mental healthcare services (CAMHS). METHODS: This paper describes stakeholders' views on the organization of CAMHS based on a qualitative study. Ten in-depth interviews with high profile stakeholders were complemented by roundtable discussions (n = 30). RESULTS: This diagnostic analysis illustrated that the system is in serious trouble characterized by fragmentation and compartmentalization. CONCLUSION: The findings create a sense of urgency that should be used to initiate a system reform of the Belgian CAMHS system.