CHARACTERISTICS OF REFERRAL CASES TO CHILD AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) IN BRUNEI DARUSSALAM.
NASIM S1 and HO H2
1Child and Adolescent Psychiatry, Linn Dara Inpatient Unit, Cherry Orchard Hospital, Dublin, Ireland.
2Department of Psychiatry Services, Raja Isteri Pengiran Anak Saleha Hospital, Ministry of Health, Brunei.
Introduction: The Child and Adolescent Mental Health Service (CAMHS) team at Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital is a developing service which provides mental health assessment and subsequent management for those presenting below the age of eighteen years. This study aims to describe the source of referrals, demographic details, diagnoses, interventions and outcomes for all new patients assessed by CAMHS during a period of one year. Method: All new referrals assessed by CAMHS between 1st July 2016 and 30th June 2017 were included. Each new referral was designated as a ďcaseĒ. Data were collected from the departmentís outpatient register and the hospitalís electronic patient information system, Brunei Health Information Management System (Bru-HIMS). Diagnostic Data was collected from the recorded ICD-10 diagnosis recorded on Bru-HIMS and cross checked with patientís written case notes. Results: 60 cases were seen over the year, with an average of 5 cases per month. The highest proportion of referrals came from developmental pediatricians (23.3%). The mean age of presentation was 12.5 (range 2-18) years. The most common diagnostic category was disorders of psychological development (ICD-10: F80-89). In terms of intervention, only 20 (33.3%) cases were prescribed medication while 40 (66.7%) cases were offered non pharmacological interventions. In terms of management outcome, 10 (17%) cases were discharged, 45 (75%) cases were followed up at the out-patient clinic and 5 (8%) cases were lost to follow up after the initial assessment. Conclusions: CAMHS is a developing service in Brunei which treats a spectrum of mental disorders, most commonly disorders of psychological development and emotional and behavioral disorders. Most cases are offered non-pharmacological interventions by medical staff, some with further multi-disciplinary input into their management. The development of comprehensive multi-disciplinary and multi-agency management should be a priority in this developing country with a substantial young population.
KEYWORDS: Brunei, Child psychiatry, Child mental disorders, Child health services, Referrals, Southeast Asia
Correspondence: Dr. Sobia Nasim, MBBS, MRCPsych, MCPI, DHSM, Linn Dara Inpatient Unit, Cherry Orchard Hospital, Ballyfermot, Dublin 22, Ireland
Brunei Int Med J. 2018;14:102-109