Inpatient Child Psychiatry Service in Turkey

What is Inpatient Child Psychiatry Service?

Child Psychiatry hospitalization is the diagnosis, follow-up and treatment of children and adolescents under the age of 17 in order to intervene in situations that cannot be controlled by outpatient treatment, or to intervene in urgent or crisis-causing problems, and sometimes to clarify the diagnosis.

In Which Cases are Child Psychiatric Hospitalizations Occur?

Child psychiatric hospitalizations may be necessary in the following cases;

• Patients experiencing severe behavioural problems, suicidal thoughts, acute psychotic-manic attacks, severe anxiety attacks, aggression, severe anger attacks that are difficult to cope with at home,
• Patients resistant to outpatient treatment,
• Patients who do not accept treatment but pose a threat to themselves or others,
• Substance abuse – patients experiencing withdrawal,
• Situations where outpatient treatment is difficult,
• Clinical situations where outpatient treatment will take a long time and need to be progressed quickly,
• Patients requiring diagnostic follow-up,
• Management of psychiatric-medical conditions that require urgency (prolonged hunger, eating disorders, etc.)

Why is Inpatient Treatment Recommended for Children?

The most important reason for recommending inpatient treatment to patients is to ensure the safety of the patient and those around him. Intervention in emergency crises, an emergency approach to situations where the patient or family is thought to be unable to make a sound decision is the basic requirement for hospitalization. Apart from this, child and adolescent psychiatric hospitalization is required for the patients who refuse treatment or in cases where serious problems may be encountered if they do not receive treatment, also for arranging the drug treatment of patients who are resistant to the drug or have frequent side effects while drug treatment is being applied.

How Are Patients Treated in the Inpatient Child Psychiatry Clinic?

In the Inpatient Child Psychiatry Clinic, child and adolescent psychiatrists, psychologists, nurses, dieticians and auxiliary staff work as a team. The most appropriate clinical approach to the patient’s condition is offered to the patients. The request for necessary tests and examinations, diagnostic observation and drug treatments are arranged by the child and adolescent psychiatrist. Individual – group psychotherapies of the patients are carried out by a child and adolescent psychologist. Medical follow-up-procedures, daily routines, sleep-eating patterns of the patients are carried out by nurses. Art-rhythm therapies, group therapies, sports-activity hours are included as additional therapies in the treatment of child and adolescent psychiatry hospitalizations. When necessary, the dietician is informed in order to create a patient-specific eating pattern.

What are the Tests and Evaluations Performed in Child Psychiatry Hospitalizations?

A number of tests and examinations are carried out in order to evaluate the patient’s medical and psychiatric condition and to prepare for treatment in child psychiatry inpatient treatments.

Medical Reviews of Child Patients

In order to evaluate possible organic disorders or drug side effects in patients, radiological tests, blood tests and urine tests are used when necessary.

Psychiatric Examination of Child Patients

It includes tests and scales that can help psychiatric diagnosis in patients.

What is Done During the Day in the Child Psychiatry Clinic?

The following therapies and practices during the day in child and adolescent psychiatry hospitalizations at Moodist Hospital are as follows;

• Good morning meetings
• Doctor visits
• Doctor family interviews
• Group therapy
• Psychologist interviews
• Family-psychologist interviews
• Art-rhythm therapies
• Social events
• Table tennis and Foosball
• Sport
• Garden hours

What are the General Rules in Inpatient Child Psychiatry Clinic?

It covers the rules of Inpatient Child Psychiatry Service and some special rules for children and adolescents.

• In paediatric and adolescent psychiatry hospitalizations, patients are expected to comply with the clinical rules and keep up with the clinical functioning.
• The patient complies with the medical treatments that the doctor deems appropriate.
• The use of electronic devices in child and adolescent psychiatry inpatient treatments is decided by the treatment team. The use of phones, tablets and any device that can connect to the internet is not allowed for the first 1 week. After 1 week, a re-evaluation is made.
• It is important for patients to establish a regular sleep rhythm. Patients are expected to comply with sleep-wake times.
• It is forbidden to establish a special relationship with a person in the clinic or to exhibit behaviours that will disrupt the treatment compliance of other patients.
• It is forbidden to enter the rooms of other patients.
• Verbal or physical violence, swearing and using slang are prohibited in child and adolescent psychiatry hospitalizations.
• In the inpatient treatment of child and adolescent psychiatry, the patient is first warned against the patient’s behaviours that harm others or himself. It is then treated with behaviour and medication. Physical intervention can be performed in cases where the patient does not comply and the problematic behaviour is not stopped.
• It is forbidden to take anything from outside that is not controlled by the treatment team during child and adolescent psychiatry hospitalizations.
• It is forbidden to bring alcohol, drugs, sharp tools, lighters, etc. into the Clinic during child and adolescent psychiatry inpatient treatments.

Things to Consider Before Coming to Child Psychiatry Hospitalization

Before the child is admitted to adolescent psychiatry hospitalization, the child’s concerns should be learned by taking into account the emotional difficulty that the child will experience, and correct and simple answers should be given to his questions. Not frightening the child with hospitalization, but getting information about the process when hospitalization is necessary and informing the child about the subject will be beneficial in reducing the child’s anxiety.

It should be informed that this is a treatment process and is temporary. Not talking too much about the disease, not making labels, not judging, is another important issue that needs attention.

It should be explained that there may be some rules during hospitalization.

It is important to pay attention to this issue and to give this assurance to the child, as the cooperation between the family and the treatment team in child-adolescent psychiatry hospitalization is of great importance for the course of the patient’s treatment.

The decision for psychiatric hospitalization in children and adolescents is made with the cooperation of the doctor and family. The child does not have to make any decisions. The child should not be left in a dilemma.

The parent-child relationship should not be allowed to be damaged, communication should be kept strong, it is important for the parent to give brief information about the necessity of the situation and state that you support him.

Before the child and adolescent psychiatry hospitalization, you should have previous treatments and tests with you.

Information and Opportunities for Families of Inpatient Child  Psychiatry Clinics

Families are informed by the treatment team in child and adolescent psychiatry hospitalizations. Families are invited for a face-to-face interview within the first 2 working days after hospitalization. In the following process, the physician informs by phone once a week or face to face, and the psychologist informs twice a week by phone or face to face. Patients can talk to their families on the extension line during hours that will not cause clinical problems, families can call them from the same line, and receive information from nurses when necessary.

Family visits are carried out twice a week. This frequency can be increased when necessary, or visits can be restricted if it is thought to be negative for the course of treatment.
The cooperation of families with the treatment team during inpatient treatment of child and adolescent psychiatry is important for the course of treatment. It is important for the relatives of the patients to comply with the clinical rules and to adapt to the treatment team.

Discharge decision; The most appropriate time for the treatment of the child is decided by the child and adolescent psychiatrist by evaluating the patient’s psychiatric condition, risk factors, readiness for outpatient follow-up, the patient’s and family’s demands and expectations in detail.

How is Safety Ensured in the Child  Psychiatry Clinic?

In order to ensure safety in child and adolescent psychiatry hospitalizations, body searches and detailed searches of the belongings brought by the patients are carried out during the entrance to the clinic. Items that are considered to be dangerous in terms of service are not taken into service.

If there is, a body search is also carried out for the patient’s companion and the relatives of the patients who come to visit. Unopened food and beverages brought to the service by the visitor in their original packaging are accepted to the service after being checked by the personnel. Food and beverage is not accepted in glass, porcelain, tin cans.

In cases of leaving the hospital on leave, a body search is performed again before entering the service. In cases where the treatment team deems appropriate, the patient’s room and belongings can be searched again.

During the child and adolescent psychiatry hospitalization, the risk of self-harm, suicide and aggression of the patient is determined by the responsible physician, and some codes, from mild to severe, are determined as “green, yellow, red” according to the patient’s condition and shared with the treatment team. Codes in the determined colour are labelled and pasted into the patient file.

The patient is taken to the clinic after a body search is made by the caregiver. Items that are not suitable for use are placed in the locker. Tracksuits and shoe laces, belts, valuables, personal care products (cosmetics and shaving products, etc.) brought by the patient are taken and put in the safe.

The behaviour of the patients that may pose a danger to themselves or someone else is intervened by the treatment team, accompanied by the safety team.

The information on this page has been prepared by the Moodist Psychiatry and Neurology Hospital Medical Team.