背景:在低收入和中等收入国家(LMICs),包括南非,社会心理支持服务很少。因此,社区守护者(CK)等非政府组织通常在学校提供服务。COVID-19大流行和由此产生的限制意味着儿童和年轻人(CYP)的生活改变了,对他们的心理健康产生负面影响。Further,像CK这样的组织不得不改变他们的工作流程。
方法:该项目比较了从2019年(大流行前)到2020年(大流行)的常规收集数据,以描述转诊模式发生的变化,和服务提供,.
结果:大流行前和大流行期间,CYP的大多数转诊是情感/心理支持和行为困难。2020年,一般指导的推荐增加,而对同龄人群体问题和性行为的推荐减少。Further,CK完成了更简短的签入,为越来越多的教师提供福利讲习班,父母和CYP,并在大流行期间与其他服务提供商举行了更多的咨询会议。
结论:在LMIC背景下,从基于社区的服务中常规收集的数据显示了提供支持方式的差异,给谁,在COVID-19大流行期间。临床意义,包括通过技术增加获得社会心理支持的重要性,包括在内。
COVID-19大流行对儿童的影响不成比例,最脆弱的年轻人和家庭,包括低收入和中等收入国家(LMICs)。在LMIC内,缺乏训练有素的心理专业人员和对心理保健干预的投资意味着获得帮助的机会有限。校本规定,在学校停课期间,由于禁止面对面提供服务,这可能会增加获得心理健康支持的机会。有充分的证据表明,COVID-19大流行影响了CYP的精神和情感健康。然而,人们不太了解第三部门非政府组织的需求和服务提供在此期间如何变化。因此,我们和一个非政府组织合作,居住在西开普省的社区守护者(CK),南非将了解从2019年(大流行前)到2020年(大流行前)的转诊模式如何变化,并探索CK对服务提供所做的具体调整。CK旨在为CYP提供免费的精神保健服务,他们的父母(法定监护人/主要照顾者;此后称为父母)和教师,在学校现场(www.communitykeepers.org)。结果表明,大流行前和大流行期间,CYP的大多数转诊是情感/心理支持和行为困难。2020年,一般指导和慢性/严重疾病的转诊增加,而对同龄人群体问题和性行为的推荐减少。Further,CK完成了福利讲习班,以增加教师人数,父母和CYP,并在大流行期间与其他服务提供商举行了更多的咨询会议。此外,COVID-19的限制需要减少面对面的会议,并转向更系统的支持以及对个人的电话和/或在线支持。这篇论文表明,如果像新冠肺炎大流行这样的另一场全球危机发生,需要关闭学校和/或限制面对面互动,这对在学校工作的组织来说很重要,特别是对于特别脆弱的CYP,调整他们的提供,以实现持续的支持。Further,关于CK的数据收集给出了具体建议,可用于支持跨类似设置的增长和理解服务提供模式。
BACKGROUND: In low- and middle-income countries (LMICs), including South Africa, there is a paucity of psychosocial support services. Therefore, services are often provided in schools by non-government organisations like Community Keepers (CK). The COVID-19 pandemic and resultant restrictions meant that children and young people\'s (CYP) lives changed, negatively affecting their mental health. Further, organisations like CK had to change their working processes.
METHODS: This project compared routinely collected data from CK from 2019 (pre-pandemic) to 2020 (pandemic) to describe the changes that occurred in referral patterns to, and service provision by, CK.
RESULTS: Both pre-pandemic and during the pandemic, most referrals of CYP were for emotional/psychological support and behavioural difficulties. In 2020, referrals for general guidance increased, whilst referrals for peer group issues and sexuality decreased. Further, CK completed more brief check-ins, provided wellbeing workshops to increased numbers of teachers, parents and CYP, and had more consultation sessions with other service providers during the pandemic.
CONCLUSIONS: Routinely collected data from this community-based service in a LMIC context shows differences in the way that support was provided, and to whom, during the COVID-19 pandemic. Clinical implications, including the importance of increasing access to psychosocial support via technology, are included.
The COVID-19 pandemic disproportionately impacted children, young people and families who are most vulnerable, including those in low- and middle-income countries (LMICs). Within LMICs, the lack of trained psychological professionals and investment in mental healthcare interventions means access to help is limited. School-based provision, which may increase access to mental health support was curtailed during school closures when face-to face service provision was prohibited. It is well-documented that the COVID-19 pandemic impacted CYP’s mental and emotional well-being. However, it is less well understood how the need and service provision of third sector non-government organisations changed during this time. Thus, we partnered with a non-government organisation, Community Keepers (CK) who are based in Western Cape, South Africa to understand how referral patterns changed from 2019 (pre-pandemic) to 2020 (peri-pandemic) and explore the specific adaptations that CK made to service provision. CK aims to provide free mental health care services to CYP, their parents (legal guardians / primary caregivers; henceforth referred to as parents) and teachers, on-site at schools (www.communitykeepers.org). Results suggest that both pre-pandemic and during the pandemic, most referrals of CYP were for emotional/psychological support and behavioural difficulties. In 2020, referrals for general guidance and chronic/serious illness increased, whilst referrals for peer group issues and sexuality decreased. Further, CK completed wellbeing workshops to increased numbers of teachers, parents and CYP, and had more consultation sessions with other service providers during the pandemic. In addition, COVID-19 restrictions necessitated a reduction in face-to-face sessions and a move towards more systemic support as well as telephonic and/or online support to individuals. This paper demonstrates that should another global crisis like the Covid-19 pandemic occur, necessitating school closures and/or restrictions to in-person interaction, it will be important for organisations working in schools, particularly with CYP who are particularly vulnerable, to pivot their provision to enable continued support. Further, specific recommendations for CK were given regarding data collection, that can be used to support growth and understanding service provision patterns across similar settings.