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Official document and timeframe
A Strategy for the Mental Health of Children and Adolescents for 2016-2020 have been adopted by the Romanian Government in November 2016 through Government Decision.
Young people over 19 are not among the target groups of the Strategy for the Mental Health of Children and Adolescents for 2016-2020, but they are targeted by the Health Strategy 2014-2020, that includes a specific objective of promoting mental health.
Main elements and key objectives
The needs identified by the Strategy for the Mental Health of Children and Adolescents for 2016-2020 are:
- Developing services to promote the mental health of the child and adolescent and to prevent mental disorders of children and adolescents through partnership between the education system, the health system, the social services system and the justice system by developing parenting information and counseling services, implementation of mental health prevention programmes such as prevention of anxiety and depression, prevention of suicide, prevention of aggressive behaviours and development of social and emotional intelligence of children and adolescents;
- Developing and implementation of a comprehensive and complex database and establish methods and rules for collecting and processing target group data;
- Developing of child psychology modules in medical education curricula and programmes and in the training of teachers;
- Development of early identification and intervention services for children at risk of developing mental health disorders and children with a diagnosed mental health disorder by family doctors and school doctors;
- Improving the infrastructure and services of Mental Health Centres;
- Development of hospital services as specialized services for children and adolescents with mental health disorders by forming and training multidisciplinary teams in the hospitals;
- Continuous training of professionals.
The objectives targeting young people (adolescents) of the Strategy for the Mental Health of Children and Adolescents for 2016-2020are:
- Rising awareness of the population at national level on the well-being of children and adolescents and their mental health, through national campaigns and locally organised events;
- Promote and develop the mental health protection factors of children and their parents, through training of all involved professionals: teachers, family doctors, paediatric doctors etc.
- Early identification of children and adolescents at risk of developing mental health disorders, through developing and implementation of a comprehensive and complex database and establish methods and rules for collecting and processing target group data
- Early identification of socio-emotional and behavioural difficulties of children and adolescents
- Early interventions for children and adolescents at risk of developing mental health disorders and socio-emotional and behavioural difficulties
- Prevention of anxiety disorders and depression of children and adolescents at risk, through seminars
- Prevention and early interventions in aggressive physical and verbal behaviour of the child and adolescent
- Development of specialized services integrated into mental health centres
- Development within the mental health centres of evaluation and intervention services for the mental health of children and adolescents
- Development and implementation of educational interventions for children with mental health disorders in kindergartens, schools and detention centres (educational centres, detention centres) for juvenile delinquents
- Developing complex services and interventions for children with severe mental health disorders in institutions that hold children
- Development of specialized crisis intervention services in juvenile delinquency sections and detention facilities / probation services
The specific objective of promoting mental health in the National Health Strategy 2014-2020 proposes as main elements:
- Increasing the access to mental health services by developing standards for mental health services, specialised training of professionals and information campaigns;
- Diversification of mental health available services.
The target groups of the Strategy for the Mental Health of Children and Adolescents for 2016-2020 are:
- Children and adolescents, their parents;
- Children and adolescents at risk of developing mental health disorders (children exposed to verbal and physical violence, alcohol abuse and psychotropic substance abuse, chronic somatic diseases of parents, disorganised families, extreme poverty, children with somatic diseases chronic children, children with parents working abroad) and their parents;
- Children and adolescents whose parents are diagnosed with mental health disorders;
- Children and adolescents diagnosed with mental health disorders and their parents;
- Children and adolescents with special protection measure;
- Children and adolescents from the units under the National Administration of Penitentiaries;
- Children and adolescents in probation services supervision;
- Children and adolescents with mental health disorders who have committed criminal offenses.
Government authority responsible for the implementation
The Ministry of Health is the main responsible authority for the implementation of the Strategy for the Mental Health of Children and Adolescents for 2016-2020, mainly through the National Centre for Mental Health and Anti-Drug Fighting under the Minsitry of Health. Other authorities are also responsible for activities planned:
- the General Secretariat of the Government, for coordination of the other actors
- the Ministry of Education, responsible for psih-pedagogical assistance and first medical assistance for all students in schools
- the National Authority for the Protection of Persons with Disability, Children and Adoptions, institution responsible for monitoring respect for the rights of the child in Romania
- the National Prisons Administration at the Ministry of Justice, and the National Directorate of Probation, institutions responsible for monitoring and assisting young people in detention and probation
- the Prosecution Office, institution responsible for the legal representation of all persons without legal capacity to exercise their rights, including persons (including children and young people) with mental health disorders
- the Ministry of Internal Affairs and the National Police, responsible for intervening in situations of abuse, neglect and exploitation of the child and young people (including the one with mental health disorders), including those of domestic violence against the child, this specialized state institution having the powers to notify the local public administration authority provided by law to intervene in cases where the rights and interests the baby are endangered
Monitoring/assessment/evaluation of the implementation of the strategy
The National Centre for Mental Health and Anti-Drug Fighting, subordinated to the Ministry of Health is responsible for the elaboration of an annual report on the implementation of the strategy. As the Strategy have been adopted in November 2016 no implementation report have been drafted until December 2018.
No updates have been made to the present Strategy for the Mental Health of Children and Adolescents for 2016-2020.
Mental Health legislation was significantly changed in Romania in 2002 upon approval of the Mental Health and Protection of Persons with Mental Disorders Law - Law 487/2002. This law created a legal framework for actions in Mental Health. The law established that responsibility for promotion and prevention of mental health lies with the Ministry of Health and Family, Ministry of Education and Research, Intern Ministry, Ministry of Youth and Sport, Ministry of Labour and Social Solidarity, National Council of Audio-visual, non- governmental associations, professional associations and others. This law protects the rights of mental health service users and establishes the criteria for admission to a psychiatric unit, including the criteria for compulsory admission.
The National Programme of Mental Health has 2 sub-programmes: one for psychiatric and psycho-social pathology and another for sub-programmes for prevention and treatment of drug dependence. The sub-programmes are delivered in psychiatric hospitals and psychiatric departments of the General Hospitals and Mental Health Centres.
The major activities, coordinated from the sub-programmes for prevention and treatment of drug dependence, are: substitution treatment with opioid agonists, testing the drugs metabolites in specialised units and treatment of intoxication with drugs. The objectives of this sub-programme are to increase social rehabilitation of the patients and the decrease the relapse rate of patients with drug dependence.
The National Programme of Mental Health is funded by the state budget through the budget of the Ministry of Health and its implementation is coordinated by the National Centre for Mental Health and Anti-Drug Fighting.
The number and types of mental health services targeting all patients (including young people), according to the National Programme of Mental Health, include:
- psychiatric hospitals: (i) acute psychiatric departments in general hospitals (75), (ii) psychiatric hospitals (34 acute and chronic).
- 20 Day Care Centres
- 52 Mental Health Centres (36 for adults and 29 for children)
- 4 specialised addiction units and forensic psychiatric hospitals
- 150 private ambulatory offices, authorized by the Ministry of Health
The National Centre for Mental Health and Anti-Drug Fighting can develop policies/programmes/projects/initiatives especially targeting young people. According to the institutions annual reports, representing the main monitoring tool, activities in 2015 included the training of school and family doctors for early detection of mental health problems among children and young people. No other youth targeted activity has been reported (with the exception of the development of the Strategy for the Mental Health of Children and Adolescents for 2016-2020).