Children and adolescents are living in a world affected by continuous transitions. A phenomenon with a double meaning: it implies a life of change in a constantly evolving environment, as well as a possible a break of balance: a loss of equilibrium. Transition, the leading theme of the ESCAP 2017 Congress, contains many aspects that are relevant to youth mental health.

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A first important issue is transition on a socio-cultural level. Children and adolescents are experiencing contemporary changes such as migration and globalization. For many children these changes have developed dramatically in the last decade – Europe is now being confronted with the turmoil in Syria, North Africa and other parts of the world, with the daily reality of the refugee crisis visible in its backyard. Mental health professionals and many other care providers are facing the end of the safe haven and are up against a long-term challenge, the scope and dimension of which are unknown. Professionals are called to offer care devices and psychotherapeutic approaches that allow this vulnerable population to overcome these difficulties, by redefining the changes to prevent serious breakdown. “We take the role of providing evidence-based knowledge and guidance to refugee helpers. This should and will be the role of ESCAP in this situation, where many children have to live through such radical experiences”, says professor Dimitris Anagnostopoulos (Athens, Greece), board member of ESCAP and in charge of the ESCAP refugee project, ‘ESCAP for mental health of child and adolescent refugees’. Professor Anagnostopoulos and his team will be giving a keynote lecture on this subject at the Geneva congress.

Organizational aspects
Another focus of the ESCAP Congress in Geneva will be transition in terms of systems of child and adolescent mental health care. Outcomes of new research will add to the congress attendees’ understanding of the development of child and adolescent psychiatric disorders, influenced by the many current dynamics. Various lecturers will discuss ways in which mental health systems could adapt to changing circumstances and underline the growing importance of professional changes such as early intervention.
“A new approach is necessary”, according to professor Patrick McGorry (Australia), keynote speaker at ESCAP 2017. “Young people do not often contact or look for support with the existing care and support services and organizations. This raises concerns and questions about the accessibility and appropriateness of the support and care offered, in particular for young people with mental health problems which could have a long-term impact.” McGorry has advocated lowering the threshold of care with an approach that enters the daily environment of young people and actively involves them in ‘their’ mental health issues. McGorry: “Cross-sectoral cooperation based on what young people with mental health issues need in order to fully participate in education or work should be the key principle in this approach, meaning cooperation between schools, labour market agencies, employers, social- and youth work and health care providers.”

Affordable care
“Consequently, mental health professionals are challenged to support their patients at different stages of their lives and in different contexts, such as family life, at school and in their peer groups. The purpose will have to be: offering affordable care services, so that, where there is a change, care can continually be assured”, says professor Stephan Eliez, president of ESCAP and chair of the ESCAP 2017 programme committee.

Cross-disciplinary collaboration
This connects the congress theme to the urgency of collaboration. The transition of patients from youth psychiatry to other medical disciplines – such as paediatrics – and child and adolescent psychology has gradually become a professional routine in European youth mental health care. Many psychologists were welcomed in child and adolescent psychiatry; psychotherapeutic approaches are gaining ground in treatment programmes and psychological research has shown to be very worthwhile. The Geneva congress will explore these topics more in-depth and also intends to examine the collaboration with allied, non-medical disciplines, such as: speech therapy, ergo therapy, moto therapy, et cetera. The congress programme intends to present models for joining forces and performing research jointly to increase an evidence base for combined treatments. “This will inevitably make the pendulum swing back to clinical psychiatry. Child psychiatrists will be forced to take a critical look at themselves”, says ESCAP board member and head of research, Johannes Hebebrand (Germany). “For traditional child psychiatrists this might be one of the toughest transitions. We have known for a long time that psychiatric disorders are indeed complex with no easy fix or solution or therapy. We now need a transition into stratified approaches which go beyond the relatively simple diagnostic categories.”

Programme scope

The ESCAP 2017 programme committee has shown courage and ambition by attacking a congress theme as broad and deep as ‘Transition’. Dr Hélène Beutler, member of the programme team and co-president of the hosting Swiss Association for Child and Adolescent Psychiatry (SSPPEA/SGKJPP), says: “So many delegates were pleased with the scope of the congress programme, last year in Madrid. There was something for everybody. For the congress in Switzerland we will be pursuing the same course. Hopefully this congress will allow clinicians and researchers, psychiatrists in independent practices and those who are committed to institutions to find the answers that will enhance their daily involvement with children and adolescents with mental disorders. The experience of multi-dynamic change unites us – transition must be on everyone’s mind.”

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