IntroductionOne in ten children and adolescents experience mental health difficulties at any given time, yet only one third of those suffering access treatment. Untreated mental illness predisposes to longstanding individual difficulties, and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness in children and adolescents, identified as a key deterrent to treatment, have had limited success, and research is scarce.AimsTo gain a better understanding of the stigma experienced by children and adolescents with mental health difficulties.ObjectivesWe conducted a systematic review of the literature examining stigma and self-stigma towards children and adolescents with mental health difficulties, in order to better understand the extent and type of discrimination directed towards this particularly vulnerable group.MethodsFollowing PRISMA guidelines, the databases Pubmed, PsychINFO and Cochrane were searched for original research published between 1980 and 2014, assessing public stigma (i.e. the reaction of the general public) and self-stigma (i.e. internalized public stigma) towards children and adolescents with mental health difficulties.ResultsThirty-seven studies were identified, confirming that stigmatization towards children and young people suffering mental health difficulties is a universal and disabling problem. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and avoidance of interventions.ConclusionsThe findings confirm that stigmatization of mental illness is poorly understood due to a lack of evidence and methodological discrepancies. Implications of the findings are discussed, and suggestions made for future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe long-term management of psychiatric wounded patients with prolonged disorders requires a rethinking of our practice of care.ObjectivesThe aim is to propose an integrative model of all valid therapies in the post-traumatic-stress disorder while taking care of comorbidities and ensuring patient support in the different administrative procedures that permit reconstruction. Repeated short-term hospitalizations can meet this objective by mobilizing resources, creating group dynamics, restoring a space of safety, allowing a rupture with the environment, preventing recurrence of crises, and by encouraging the histicization of trauma by the temporal sequences of intra/extra-hospitalisation repetition.MethodWe propose, by means of a review of the literature, to discuss on a psychopathological level the interest and limits of this mode of care.ResultsThis work reveals the specific therapeutic effects of repeated programmed hospitalizations, which constitute a new modality of institutional psychotherapy.ConclusionRethinking the place of hospitalisation in the management of psychiatric illnesses can be useful to all psychiatrists who follow patients with chronic and co-morbid disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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