© 2020, Springer Medizin Verlag GmbH, ein Teil von Springer Nature. Mental and social burdens in childhood have the potential to result in irreversible chronification with lifelong increased mental and somatic morbidity, especially when they remain unrecognized and untreated. The task of pediatric and adolescent physicians and surgeons as the first contact partner is to keep an eye open for the mental state and the living environment of their young patients and in the case of conspicuousness to involve specialists as soon as possible. The symptom and disease spectrum, prevalence and needs in the field of psychosocial conspicuousness are presented in detail. The tasks, prerequisites, models and course of the consultation-liaison care in hospitals are illustrated by means of case vignettes. All aspects are systematized with the focus on the resulting structure, process and results outcome. Where there are indications of conspicuousness, psychosocial teams should be included and if necessary psychosomatic, psychotherapeutic or psychiatric treatment initiated. A psychosocial undertreatment in primarily somatically oriented clinics leads to increased temporal delays until relevant symptoms are recognized and the diagnostic classification takes place. For children and adolescents this is associated with high risks with respect to sustained impairments of their development and social participation. Apart from the individual suffering and high consequential costs in the healthcare system, this results in permanent impairments in the quality of life, associated with neediness and dependency on social services. A psychosocial team with appropriate personnel and competent specialist leadership, to which the clinically active personnel of the relevant specialist groups belong, is an integral component of every modern hospital or department of pediatric and adolescent medicine or surgery. The inclusion of the psychosocial field occurs at all levels of the medical center. The supervision and advanced training of team members as well as delegation of tasks at hand and responsibilities are organized by the team leader. As long as a psychosomatic ward is available, it stands to reason that the leadership also coordinates the other psychosocial services. A formally regulated cooperation with external specialists for tasks that the internal team cannot undertake is obligatory. The background to the tendency to structural understaffing and undertreatment are the insufficient options of service-invoicing and the lack of remuneration in the presented field. The diagnosis-related groups system has so far not included any economically relevant financing for the services provided in the pediatric psychosocial consultation-liaison care via operation and procedural key (OPS) coding. Clinics that provide an appropriate care bear financial risks that are difficult to foresee.
|Translated title of the contribution||Psychosocial care of children and adolescents in departments for pediatric and adolescent medicine and pediatric surgery|
|Journal||Monatsschrift fur Kinderheilkunde|
|Publication status||Published - 10.08.2020|